title: Complications in patients treated with plasmapheresis in the intensive care unit.
abstract: BACKGROUND
  Plasmapheresis is one of the methods of extracorporeal blood purification involving the removal of inflammatory mediators and antibodies. The procedure is used in a variety of conditions, including autoimmune diseases. The aim of the present study was to analyse the incidence of plasmapheresis-related complications in patients treated in the intensive care unit (ICU).
  
  
  METHODS
  The analysis involved 370 plasmapheresis procedures in 54 patients. The data were collected from patients' medical records, including procedure protocols.
  
  
  RESULTS
  The most common diseases treated with plasmapheresis included: myasthenia gravis (33.3%), Guillain-Barre syndrome (14%), Lyell's syndrome (9.3%), systemic lupus erythematosus (7.4%), and thrombotic thromcytopenic purpura (7.4%). The adverse side effects observed most frequently during plasma filtration were: fall in arterial blood pressure (8.4% of all procedures), arrhythmias (3.5%), sensations of cold with temporarily elevated temperature and paresthesias (1.1%, each). In most cases the symptoms were mild and transient. Severe and life-threatening episodes, i.e. shock, fall in arterial blood pressure requiring pressor amines, persistent arrhythmias and haemolysis, developed in 2.16% of procedures.
  
  
  CONCLUSIONS
  Plasmapheresis can be considered a relatively safe method of treatment of ICU patients. Continuous observation and proper monitoring of patients provided by highly trained medical personnel are essential for its safety.
authors.affiliation: II Department of Internal Diseases, Jagiellonian University Medical College, Cracow, Poland. wszczeklik@gmail.com
authors.forename: Wojciech
authors.initials: W
authors.lastname: Szczeklik
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Wawrzycka
authors.forename: Anna
authors.initials: A
authors.lastname: Włudarczyk
authors.forename: Aurelia
authors.initials: A
authors.lastname: Sega
authors.forename: Ilona
authors.initials: I
authors.lastname: Nowak
authors.forename: Bożena
authors.initials: B
authors.lastname: Seczyńska
authors.forename: Izabela
authors.initials: I
authors.lastname: Fajfer
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Zając
authors.forename: Wiesław
authors.initials: W
authors.lastname: Królikowski
authors.forename: Maria
authors.initials: M
authors.lastname: Kózka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis / Q000009:adverse effects*; D012189:Retrospective Studies