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Plasmapheresis and plasma exchange - Coggle Diagram
Plasmapheresis and plasma exchange
Definition
PLasmaphoresis
PLasma removal
Plasma exchange
Replacement with FFP
Processes
Centrifugation = specific gravity
Advantages
NO limit to the size
Disadvantages
Difficult to perform
Filtration = semi-permeable membrane
Advanatges
Can be performed on ICU
Disadvantages
Size molecule is limited by pore size
Indications
Therapeutic apheresis (ASFA) classification
First line therapy eg Gullilen barre syndrome
Secondline therapy eg acute disseminated encephalpmyelitis (ADEM) post failure of corticosteroids
Role not established eg. sepsis
Ineffective or harmful eg. rheumatoid arthritis
Plasma exchange
Neurology
AIDP (GBS)
ADEM
CIDP
Myasthenia gravis
LEMS
Multiple sclerosis
Renal
Wegeners
Goodpastures
Antibody-mediated renal transplant rejection
Myeloma cast nephropathy
Haematology
TTP
Atypical HUS
Sickle cell disease resulting in an acute stroke
Metabolic
Wilsons
Familial hypercholestereamia
Immunology
SLE
Catastrophic anti-phospholipid syndrome
Complications
Line related
Infection
Misplacement
Pnumothorax
Bleeding
Arrhythmia
Procedure specific
Hypotension
Hypothermia
Transfusion reactions
Thrombocytopenia
Hypocalcaemia
Treatment plan
30-40ml/kg or plasma removed
One exchange = 66% intravascular volume
Two exchanges = 85%