Dose:-
7 sessions over 14 days
60mls/kg
5% Albumin
Use of FFP at end of procedure- at discretion of treating doctor
Other aspects of plasma-exchange applies.
Anticoagulation: Heparin 50u/kg stat than 1000u/h
target ACT 1.5-2.0X normal
adjust dose accordingly
stop heparin 30min prior to end of procedure
To avoid hemolysis, PEx must be done at
TMP 50-60mmHg
Qb 100-150mls/min
Complications of PEx
Hypotension- bld loss, decrease oncotic pressure
Bleeding d/t reduction in coagulation factors
Edema- reduction of intravascular oncotic pressure
Loss of cellular elements
Ethylene Oxide hypersensitivity
Related to anticoagulation
Bleeding- heparin related
Hypocalcemia leading to arrhythmias/ hypotension/ numbness/ tingling sensation
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