Concurrent centrifugation plasmapheresis and continuous venovenous hemodiafiltration
Concurrent centrifugation plasmapheresis and continuous venovenous hemodiafiltration
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DOI：
10.1007/s004670050004
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发表时间：
2000-01-01
影响因子：
3
通讯作者：
Theodorou, AA
中科院分区：
文献类型：
--
作者：
Yorgin, PD;Eklund, DK;Theodorou, AA
连续性静脉-静脉血液滤过/血液透析滤过（CVVH/D）通常用于为血流动力学不稳定的重症患者提供肾脏替代治疗。有时，对于某些疾病，包括免疫介导的急性肾衰竭、脓毒症、暴发性肝衰竭和血栓性血小板减少性紫癜/溶血性尿毒症综合征，需要增加血浆置换治疗。大多数三级医疗机构提供离心血浆分离法而不是膜血浆分离法，因为需要治疗性血浆置换和细胞血液制品的分离。我们报告了一种新的技术，离心血浆置换和CVVHD（P-CVVHD）相结合，并同时使用。使用Hospal BSM 22机器与Multiflow 60血液滤过器和Cobe Spectra连续细胞分离器并行过滤患者血液。P-CVVHD在技术上是可行的，可以长期使用，风险有限。与间断CVVH/D和血浆置换联合治疗相比，P-CVVHD可能具有优势。
Continuous venovenous hemofiltration/hemodiafiltration (CVVH/D) is commonly used to provide renal replacement therapy for critically ill patients who are hemodynamically unstable. Occasionally, the addition of plasmapheresis therapy is necessary for some conditions, including immune-mediated acute renal failure, sepsis, fulminant hepatic failure, and thrombotic thrombocytopenic purpura/hemolytic uremic syndrome. Most tertiary care facilities provide centrifugation plasmapheresis instead of membrane plasmapheresis, because of the requirement for both therapeutic plasma exchange and pheresis of cellular blood products. We report a new technique where centrifugation plasmapheresis and CVVHD (P-CVVHD) are combined and used concurrently. Blood from the patient was concurrently filtered utilizing a Hospal BSM 22 machine with a Multiflow 60 hemofilter and a Cobe Spectra continuous cell separator in a parallel configuration. P-CVVHD is technically possible and can be used for long periods of time with limited risks. There may be advantages to P-CVVHD compared with discontinuous combined CVVH/D and plasmapheresis therapy.