Clinical studies on adequate dosage of heparin during immunoadsorption with membrane plasmapheresis.
Heparin has been used as an anticoagulant during hemodialysis and plasmapheresis. Recently, immunoadsorption with membrane plasmapheresis (IAP) has been used for treatment of myasthenia gravis and multiple sclerosis. Ten patients were examined. Plasma heparin levels were studied before IAP, 30 minutes, 60 minutes, 90 minutes, and 120 minutes after the start of IAP, and at the end of IAP. Prothrombin time, activated partial thromboplastin time (APTT), bleeding time, plasma fibrinogen levels, fibrin degradation products, and complete blood count were measured pre- and post-IAP. In general, plasma heparin levels lower than 1 IU/ml during plasmapheresis are adequate. The dosage of 40 IU/kg/hr of heparin administered during IAP resulted in plasma heparin levels lower than 1 IU/ml. APTT pre-IAP (36.8 +/- 3.4 sec) were nearly one-half values of APTT post-IAP (6.2 +/- 9.70 sec). In conclusion, 40 IU per kg of the body weight per hour is an acceptable dose of heparin during IAP.
Hosokawa
S
S
Department of Urology and Hemodialysis Center, Utano National Hospital, Kyoto, Japan.
Oyamaguchi
A
A
Yoshida
O
O
D006493:Heparin / Q000008:administration & dosage* / Q000097:blood; D006801:Humans; D007163:Immunosorbent Techniques; D008567:Membranes, Artificial; D009103:Multiple Sclerosis / Q000097:blood / Q000628:therapy; D009157:Myasthenia Gravis / Q000097:blood / Q000628:therapy; D010314:Partial Thromboplastin Time; D010956:Plasmapheresis / Q000379:methods*; D011517:Prothrombin Time
D008567:Membranes, Artificial; D006493:Heparin