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Continuous plasma exchange with dialysis for thrombotic microangiopathy in intensive care unit: Retrospective observational study
Author(s) -
Satoh Kasumi,
Okuyama Manabu,
Irie Yasuhito,
Kameyama Koumei,
Kitamura Toshiharu,
Nakae Hajime
Publication year - 2021
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.13654
Subject(s) - medicine , intensive care unit , thrombotic microangiopathy , dialysis , fibrinogen , adverse effect , intensive care medicine , albumin , thrombotic thrombocytopenic purpura , platelet , disease
Continuous plasma exchange with dialysis is a novel method of blood purification and is a modification of the plasma exchange. Technically, this process suggests a reduction in adverse events, cost‐effectiveness, and compatibility with hemodynamic instability. The therapeutic effect of plasma exchange on thrombotic microangiopathies has been established. We present three clinical cases in the intensive care unit that illustrate continuous plasma exchange with dialysis as a flexible blood purification therapy for critically ill patients; a radical treatment, thrombotic microangiopathies; supportive therapy, multiple organ failure; and fluid balance regulator. The retrospective analysis of 13 continuous plasma exchange with dialysis sessions showed that the platelet count increased significantly ( p = 0.0096) after its administration. The total protein, albumin, fibrinogen, or calcium did not decrease significantly after continuous plasma exchange with dialysis, suggesting therapeutic efficacy and fewer adverse events. A prospective study on thrombotic microangiopathies for continuous plasma exchange with dialysis is currently underway.