title: The hemostatic balance after plasma-exchange transfusion in myasthenia Gravis.
abstract: BACKGROUND
  To study the effects of plasma-exchange on removal and recovery of haemostatic factors and inhibitors using albumin or PPS as replacement fluid.
  
  
  METHODS
  
  
  
  METHODS
  Prospective, noninterventional study.
  
  
  METHODS
  Medical intensive care unit of a university hospital.
  
  
  METHODS
  The study included 11 consecutive patients with Myasthenia Gravis, whose haemostatic parameters were normal before plasma-exchange.
  
  
  METHODS
  Plasma coagulative factors and inhibitors were studied before at the end of and 24 hours after each exchange.
  
  
  RESULTS
  Immediately after exchange plasma coagulation factors and inhibitors evaluated were reduced, except for factor VIII; 24 hours later only fibrinogen was significantly decreased; D-Dimer was not found increased; the platelets, after exchange, were at normal levels.
  
  
  CONCLUSIONS
  Our data show a parallel lowering of haemostatic factors and inhibitors after plasmapheresis using material devoid of coagulation factors as replacement, this explains the absence of hemorrhagic or thrombotic complications. So we think that careful monitoring of coagulation during plasma-exchange is not useful.
authors.affiliation: Servizio di Anestesia, Rianimazione e Terapia Antalgica ASL 3, Torino.
authors.forename: E
authors.initials: E
authors.lastname: Manno
authors.forename: F
authors.initials: F
authors.lastname: Bonadeo
authors.forename: L
authors.initials: L
authors.lastname: Parigi
authors.forename: L
authors.initials: L
authors.lastname: Faccio
authors.forename: F
authors.initials: F
authors.lastname: Racca
mesh_terms: D006487:Hemostasis / Q000502:physiology*; D006801:Humans; D009157:Myasthenia Gravis / Q000097:blood / Q000628:therapy*; D010951:Plasma Exchange; D011446:Prospective Studies