Effects of replacement fluids on coagulation system used for therapeutic plasma exchange.
Therapeutic apheresis is a widely used treatment alternative for several diseases. In 29 patients with different diseases, we have monitored the PT, aPTT, thrombin time (TT), fibrinogen, D-dimer, factor VIII, IX, X, XI, XII, VWF, Protein C, S, Active Protein C Resistance (APCR) and Antithrombin-III during TPE. Patients were divided into four groups based on the replacement fluids used: 3% VARIHES or ISOHES + 4% albumin (1:1) (group 1), fresh frozen plasma (FFP) (group 2), 3% VARIHES or ISOHES (group 3) and 4% albumin (group 4). In our study, the fibrinogen level decreased to 83% of the base line level after the end of 48 h therapy. The APTT, PT, and TT increased during TPE. However no statistical difference was observed between the groups. We found a significant change in factor levels with time, only the difference in factors IX and XI between the groups was significant. In addition, factor levels measured at 48 h were close to the levels measured before aphereses. In our study, time the related change in AT-3 values was significant. Time-related changes of the Protein S and APCR were not statistical significant significant but on the other hand, we found a significant difference in AT-III and Protein C values between groups. The side effects of HES on coagulation factors and tests were comparable to those of other replacement fluids. Its low cost makes it favourable.
Tek
Ibrahim
I
Ibni Sina Hospital, Hemapheresis Unit and Blood Bank, Department of Hematology, Medical School, Ankara University, Sihhiye, 06100 Ankara, Turkey.
Arslan
Onder
O
Arat
Mutlu
M
Ozcan
Muhit
M
Akdağ
Beyza
B
Ilhan
Osman
O
D000328:Adult; D000368:Aged; D001777:Blood Coagulation / Q000187:drug effects*; D019774:Blood Coagulation Factor Inhibitors / Q000032:analysis; D001779:Blood Coagulation Factors / Q000032:analysis; D001780:Blood Coagulation Tests; D001802:Blood Substitutes / Q000494:pharmacology*; D005260:Female; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D010949:Plasma; D010951:Plasma Exchange / Q000379:methods* / Q000592:standards; D012709:Serum Albumin / Q000494:pharmacology; D013997:Time Factors
D019774:Blood Coagulation Factor Inhibitors; D001779:Blood Coagulation Factors; D001802:Blood Substitutes; D006895:Hydroxyethyl Starch Derivatives; D012709:Serum Albumin