[The choice of a program of discrete plasmapheresis in the preoperative preparation of patients with diffuse toxic goiter].

The state of circulation and its impact on the nature of hemodynamic response during discrete plasmapheresis has been studied in 91 patients with hyperthyroidism. It has been established that the nature of cardio- and hemodynamics depends on the severity of the disease and the cardiac rhythm. In patients with mild hyperthyroidism the volume of single blood exfusion (BE) should not exceed 800 ml of blood and plasma should be replaced by colloid and crystalloid preparations in the ratio of 1:1. In patients with severe hyperthyroidism and normal cardiac rhythm the volume of single exfusion should not exceed 600 ml and plasma should be replaced by cryoplasma. In patients with severe hyperthyroidism and atrial fibrillation blood exfusion should be limited to 400 ml of blood. Simultaneously with blood exfusion it is expedient to perform cryoplasma infusion. Glycerol trinitrate and calcium antagonists may be used to prevent pulmonary hypertension.