Terapotik plazma değişiminde kullanılan replasman sıvılarının plazma viskozitesi ve onkotik basınca etkisi
Özet
Effects of Replacement Fluids on Plasma Viscosity and Plasma Oncotic Pressure Used for Therapeutic Plasma Exchnage Aphresis is a procedure that consists of removing one of the component of blood and giving the remainder to donor or to patient. The aim of the therapeuthic plasma exchange (TPE) is removing patient's plasma from the body, particularly in great fraction, and exchangly this with replacement solutions by using automatic cell distrubition machine. With this procedure circulating pathogens and toxins are reduced. Before each TPE basal complete blood counts,serum protein electrophoresis, coagulation test results and serum electrolytes must be known.The efficacy of this therapy assessed only by this way. The proteins responsible for dissease may be monoclonal proteins cryoglobulins, lipoproteins,oto or alio antikors and toxins e.g. Between 1/10/2002 and 10/6/2003, 111 TPE that was performed on 42 patients in Ankara University İbn'i Sina Hospital Hematology department, Prof. Dr. Orhan Seyfj Sardaş Aferez Unit is investigated. Before the TPE, the patients whose vascular anatomy was not suitable were catheterized either by using subclavian or jugular 11 F dialysis catheter. At each seans, approximately 1-1.5 It. plasma was exchanged. The procedure was performed with albumin in patients whose albumin was under 3 gr/dl. Over this value, the exchange fluids were used with randomization. When overall results were analyzed, there was no statistical significant difference between group 1 (HES +albumin) and group 3 (albumin).The statistical difference between group 2 and 3 was signiflciant, but no difference T.C.Y3ESEL 2930 betwen group 1 and 2 were observed. According to the decreasing plasma viscosity, there was significant difference between group 2 and group 3, but there wasn't difference between group 1 and group 2. As a result, the replacement solutions used for plasmapheresis are similar when compared for hemorheologic effects, but the best replacement solution for the body physiology is fresh frozen plasma. Key Words:Therapeutic plasma exchange, plasma viscosity, plasma oncotic pressure, hemorheology.