Department of Medicine, Division of Nephrology, University of Connecticut Health Center, Farmington, Connecticut, USA.
Department of Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA.
Ther Apher Dial. 2022 Aug;26(4):836-839. doi: 10.1111/1744-9987.13757. Epub 2021 Dec 5.
Previous studies have demonstrated that a "one plasma volume exchange" would result in an estimated 63% decline in pretreatment IgG levels. We evaluated the use of prefilter dilution with normal saline as a method to prevent filter failure without decreasing the efficiency of IgG removal.
Twenty-one treatment sessions were analyzed and all received prefilter dilution with normal saline. Primary outcome was to determine whether prefilter dilution resulted in decreased treatment efficiency in removing the targeted IgG. Secondary outcome was filter failure in conjunction with the combined use of prefilter heparin and saline infusions.
All 21 treatments (100%) received prefilter dilution with saline solution and 19/21 (90.47%) also received prefilter heparin (bolus and/or hourly infusion). We demonstrated a 60%-70% decline in pretreatment IgG levels.
Prefilter dilution during membrane-based therapeutic plasma exchange based treatment did not result in a demonstrable decrease in efficiency of IgG removal while maintaining filter patency.
先前的研究表明，“一次血浆容量交换”可使预处理 IgG 水平估计下降 63%。我们评估了使用生理盐水预过滤稀释作为一种方法，在不降低 IgG 去除效率的情况下，防止过滤器故障。
分析了 21 次治疗过程，所有治疗均接受了生理盐水预过滤稀释。主要结果是确定预过滤稀释是否会降低去除目标 IgG 的治疗效率。次要结果是与预滤器肝素和生理盐水输注联合使用的过滤器故障。
所有 21 次治疗（100%）均接受了生理盐水预过滤稀释，21 次治疗中的 19 次（90.47%）也接受了预滤器肝素（推注和/或每小时输注）。我们证明预处理 IgG 水平下降了 60%-70%。
基于膜的治疗性血浆置换治疗过程中的预过滤稀释不会导致 IgG 去除效率明显降低，同时保持过滤器畅通。
