PMID: 6400415Jan 1, 1983Paper

Intensive plasma exchange in small and critically ill pediatric patients: techniques and clinical outcome

Journal of Clinical Apheresis
M FosburgS V Kevy

Abstract

Standard apheresis techniques require modification of use in children, particularly those with serious concurrent medical problems, as they are prone to apheresis-induced disturbances of volume, metabolism, and coagulation. We report 112 plasma exchanges (TPE) on 11 children, 9 of whom weighed less than 20 kg and 7 of whom were critically ill. All were treated on continuous flow apparatus; seven on centrifugal systems (CS), two on a membrane filtration system (MFS), and two on both. Perturbations of blood and red blood cell (RBC) volume were prevented by priming the extracorporeal circuits with a red cell saline mixture having an hematocrit equal to or greater than the patient's hematocrit. Priming volume and minimal flow rates were 170 ml and 40 cc/min (MFS) and 350 ml and 10 cc/min (CS). TPE dose varied from 1.3 to 3 plasma volumes. Immunoglobulins fell by the following amounts: IgG 43.7%, IgA 36.7%, and IgM 41% per plasma volume. Platelets fell by 20-90% (CS) and 5-7% (MFS). Vascular access was obtained by various means including Thomas shunts, dialysis catheters, and standard 16-19 gauge butterflies and angiocaths. Bleeding in patients with coagulopathies was prevented by using repeated small boluses of heparin to maintain ...Continue Reading

References

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Citations

Jan 1, 1990·Pediatric Neurology·B O KhatriR J Konkol
Mar 21, 2000·Transfusion Science·J B Gorlin
Nov 5, 2015·International Urology and Nephrology·Carsten HaferJan T Kielstein
Jan 1, 1993·Journal of Pediatric Surgery·N BhattacharyyaR C Shamberger
Jan 1, 1989·Journal of Clinical Apheresis·D O Kasprisin
Dec 28, 1999·Journal of Clinical Apheresis·L J McCarthyJ Goldman
Jan 1, 1997·Journal of Clinical Apheresis·D M Galacki
Jan 1, 1984·Journal of Clinical Apheresis·S V KevyM Jacobson

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