[Colloid osmotic pressure and the total protein level in assessing the safety of therapeutic plasmapheresis].

In 117 plasmapheresis procedures provided to rheumatic arthritis patients, the authors studied the changes in colloid osmotic pressure (COP), proteinemia and systemic arterial pressure depending on the plasma volume removed and on the type and volume of the substituting solution. Plasmapheresis carried out in 3 alternative regimens was not accompanied by dangerous exchange in the protein system. The substitution of the removed plasma by albumin and rheopolyglukin ensures an effective maintenance of COP just after the procedure. Since the elimination of polyglucin from the vascular system proceeds quicker than making up for protein deficiency, there is a potential danger of inadequate reduction of COP several hours after the procedure. Simple mathematic models have been proposed for the description of the COP level and proteinemia after plasmapheresis, which can be used for prognosis.