| Pentastarch as partial replacement fluid for therapeutic plasma exchange: effect on plasma proteins, adverse events during treatment, and serum ionized calcium. | |
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MedLine Citation:
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PMID: 10540365 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We compared the safety, effect on plasma proteins, and contribution to hypocalcemic toxicity of 10% pentastarch vs. 5% albumin in plasma exchange. Thirty-two neurology patients underwent 161 plasma exchange procedures. Subjects were randomized to receive either 10% pentastarch (n = 17) or 5% albumin (n = 15) as the first (1/2) of colloid replacement. The second (1/2) of colloid replacement was 5% albumin in all cases. NaCl (plus small amounts of ACD-A) accounted for (1/4) of the total return fluid. Mean total exchange volume was 3,842.6 +/- 450 ml. Hemoglobin, platelet count, coagulation parameters, and plasma fibrinogen were similar between the two groups at the outset of plasma exchange and at the time of the last (4th or 5th) procedure of the series. Immunoglobulin levels were equivalent at the outset and were reduced by plasma exchange to the same extent in the two groups. Serum albumin concentration fell significantly faster in the group receiving pentastarch. On the other hand, serum calcium, corrected for the albumin concentration, fell significantly further in the control group than in the group receiving pentastarch. Mean serum ionized calcium fell approximately 25 % in procedures using only albumin but only approximately 16% when pentastarch was used (P < 0.0001). This was reflected in the occurrence of hypocalcemic toxicity in 33.3% of procedures performed using only albumin but in only 8.1% of those using pentastarch (P = 0.0002). Pentastarch may be suitable for partial colloid replacement in plasma exchange and would have saved our hospital $127,050 to $434,280 in 1998 if used in all procedures. |
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Authors:
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G A Goss; R Weinstein |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Journal of clinical apheresis Volume: 14 ISSN: 0733-2459 ISO Abbreviation: J Clin Apher Publication Date: 1999 |
Date Detail:
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Created Date: 1999-12-21 Completed Date: 1999-12-21 Revised Date: 2005-07-26 |
Medline Journal Info:
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Nlm Unique ID: 8216305 Medline TA: J Clin Apher Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 114-21 Citation Subset: IM |
Copyright Information:
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Copyright 1999 Wiley-Liss, Inc. |
Affiliation:
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Department of Medicine, St. Elizabeth's Medical Center of Boston, Tufts University School of Medicine, Boston, Massachusetts 02135, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Blood Proteins / metabolism* Calcium / blood* Female Hetastarch / adverse effects, therapeutic use* Humans Male Middle Aged Plasma Exchange / adverse effects, methods* Plasma Substitutes / adverse effects, therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Blood Proteins; 0/Plasma Substitutes; 7440-70-2/Calcium; 9005-27-0/Hetastarch |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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