【摘 要】
：
Plasmapheresis therapies have become therapeutic tools in critical care.It is one of the modalities of treatment for autoimmune diseases.Therapeutic plasma exchange has been used for over four decades
【机 构】
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National Institute of Mental Health & Neurosciences India
【出 处】
：
BIT`s 3rd Annual World Congress of NeuroTalk-2012(2012第三届国际神
论文部分内容阅读
Plasmapheresis therapies have become therapeutic tools in critical care.It is one of the modalities of treatment for autoimmune diseases.Therapeutic plasma exchange has been used for over four decades in the treatment of autoimmune diseases.In our center we have been doing therapeutic plasma exchange for various neurological conditions, which includes Guillain-Barre Syndrome (GBS), Myasthenia in crisis and before and after thymectomy, variants of GBS like MillerFisher Syndrome and others, Chronic Inflammatory Demyelinating diseases, AIDS with neurological diseases and others.We have done maximum procedures for GB syndrome constituting 70%, for Myasthenia Gravis 25% and 5% for other conditions.We have been doing plasma exchange from the year 1997.We have done 12,000 procedures till now.So, our center does highest number of procedures in the country.For each of these patients 3 to 5 sittings of plasma exchange is done, depending upon clinical improvement, using intermittent cell separator.We exchange one plasma volume per sitting or less depending upon the patients ability to withstand the procedures.The replacement fluid used is combination of hydroxyethyl starch, normal saline and fresh frozen plasma, in most of the cases and only few received human albumin.The frequency of adverse reactions can be compared to frequency of reactions in a blood donor.It is about 2-5%.The common reactions encountered during the procedure are chills and rigors, hypotension and vasovagal reaction.It is about 2-3%.And the common reactions encountered for plasma transfusion is allergic reaction with symptoms of itching and or urticarial rash.We never encountered serious cardiac events or death during or after 24 hours of the procedure.We have not encountered septicemia following TPE.So, The TPE is quite safe procedures and can be done in any Institute caring for neurological diseases.
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