Effect of Therapeutic Plasma Exchange on Plasma Constituents in Neurointensive Care Unit Patients: A Retrospective Study

Purpose Plasma exchange is one of the recommended therapeutic procedures for autoimmune neurological conditions and involves removal of plasma over multiple sessions for exclusion of autoantibodies responsible for the disease process. This study aimed to evaluate the changes in the concentration of...

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Autores principales:	Deepti Srinivas, Kamath Sriganesh, Dhritiman Chakrabarti, Pavithra Venkateswaran
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2021
Materias:	therapeutic plasma exchange plasma proteins neurointensive care unit Anesthesiology RD78.3-87.3
Acceso en línea:	https://doaj.org/article/52bb6f7f787545dcab874cb55994ac84
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spelling	oai:doaj.org-article:52bb6f7f787545dcab874cb55994ac842021-12-02T23:53:13ZEffect of Therapeutic Plasma Exchange on Plasma Constituents in Neurointensive Care Unit Patients: A Retrospective Study2348-05482348-926X10.1055/s-0041-1734412https://doaj.org/article/52bb6f7f787545dcab874cb55994ac842021-09-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1734412https://doaj.org/toc/2348-0548https://doaj.org/toc/2348-926XPurpose Plasma exchange is one of the recommended therapeutic procedures for autoimmune neurological conditions and involves removal of plasma over multiple sessions for exclusion of autoantibodies responsible for the disease process. This study aimed to evaluate the changes in the concentration of plasma constituents with five cycles of alternate day therapeutic plasma exchange (TPE), identify contributing factors for hypoproteinemia, and examine its impact on clinical outcomes. Methods This was a single-center, retrospective cohort study involving patients with autoimmune neurological diseases who underwent at least five cycles of TPE in the neurointensive care unit (NICU). Data regarding plasma protein concentrations, serum electrolytes, fluid input/output before and after every TPE cycle and clinical outcomes in terms of duration of ventilation, and NICU and hospital stay were collected from the medical records over a 1-year period. Results The levels of plasma proteins (total protein, albumin and globulin) (p < 0.001), sodium (p < 0.001), calcium (p < 0.001), and hemoglobin (p = 0.002) declined significantly after TPE. Difference in plasma protein levels before and after TPE did not correlate with durations of mechanical ventilation and hospital and NICU stay. Difference in total protein and globulin correlated negatively with fluid balance and positively with daily protein intake (p < 0.05 for both). Conclusion A significant decrease in plasma proteins and other plasma constituents is seen with TPE. Changes in plasma proteins are related to hemodilution and protein intake. Decrease in plasma proteins did not affect duration of hospital or NICU stay and duration of mechanical ventilation.Deepti SrinivasKamath SriganeshDhritiman ChakrabartiPavithra VenkateswaranThieme Medical and Scientific Publishers Pvt. Ltd.articletherapeutic plasma exchangeplasma proteinsneurointensive care unitAnesthesiologyRD78.3-87.3ENJournal of Neuroanaesthesiology and Critical Care, Vol 08, Iss 03, Pp 197-202 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	therapeutic plasma exchange plasma proteins neurointensive care unit Anesthesiology RD78.3-87.3
spellingShingle	therapeutic plasma exchange plasma proteins neurointensive care unit Anesthesiology RD78.3-87.3 Deepti Srinivas Kamath Sriganesh Dhritiman Chakrabarti Pavithra Venkateswaran Effect of Therapeutic Plasma Exchange on Plasma Constituents in Neurointensive Care Unit Patients: A Retrospective Study
description	Purpose Plasma exchange is one of the recommended therapeutic procedures for autoimmune neurological conditions and involves removal of plasma over multiple sessions for exclusion of autoantibodies responsible for the disease process. This study aimed to evaluate the changes in the concentration of plasma constituents with five cycles of alternate day therapeutic plasma exchange (TPE), identify contributing factors for hypoproteinemia, and examine its impact on clinical outcomes. Methods This was a single-center, retrospective cohort study involving patients with autoimmune neurological diseases who underwent at least five cycles of TPE in the neurointensive care unit (NICU). Data regarding plasma protein concentrations, serum electrolytes, fluid input/output before and after every TPE cycle and clinical outcomes in terms of duration of ventilation, and NICU and hospital stay were collected from the medical records over a 1-year period. Results The levels of plasma proteins (total protein, albumin and globulin) (p < 0.001), sodium (p < 0.001), calcium (p < 0.001), and hemoglobin (p = 0.002) declined significantly after TPE. Difference in plasma protein levels before and after TPE did not correlate with durations of mechanical ventilation and hospital and NICU stay. Difference in total protein and globulin correlated negatively with fluid balance and positively with daily protein intake (p < 0.05 for both). Conclusion A significant decrease in plasma proteins and other plasma constituents is seen with TPE. Changes in plasma proteins are related to hemodilution and protein intake. Decrease in plasma proteins did not affect duration of hospital or NICU stay and duration of mechanical ventilation.
format	article
author	Deepti Srinivas Kamath Sriganesh Dhritiman Chakrabarti Pavithra Venkateswaran
author_facet	Deepti Srinivas Kamath Sriganesh Dhritiman Chakrabarti Pavithra Venkateswaran
author_sort	Deepti Srinivas
title	Effect of Therapeutic Plasma Exchange on Plasma Constituents in Neurointensive Care Unit Patients: A Retrospective Study
title_short	Effect of Therapeutic Plasma Exchange on Plasma Constituents in Neurointensive Care Unit Patients: A Retrospective Study
title_full	Effect of Therapeutic Plasma Exchange on Plasma Constituents in Neurointensive Care Unit Patients: A Retrospective Study
title_fullStr	Effect of Therapeutic Plasma Exchange on Plasma Constituents in Neurointensive Care Unit Patients: A Retrospective Study
title_full_unstemmed	Effect of Therapeutic Plasma Exchange on Plasma Constituents in Neurointensive Care Unit Patients: A Retrospective Study
title_sort	effect of therapeutic plasma exchange on plasma constituents in neurointensive care unit patients: a retrospective study
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2021
url	https://doaj.org/article/52bb6f7f787545dcab874cb55994ac84
work_keys_str_mv	AT deeptisrinivas effectoftherapeuticplasmaexchangeonplasmaconstituentsinneurointensivecareunitpatientsaretrospectivestudy AT kamathsriganesh effectoftherapeuticplasmaexchangeonplasmaconstituentsinneurointensivecareunitpatientsaretrospectivestudy AT dhritimanchakrabarti effectoftherapeuticplasmaexchangeonplasmaconstituentsinneurointensivecareunitpatientsaretrospectivestudy AT pavithravenkateswaran effectoftherapeuticplasmaexchangeonplasmaconstituentsinneurointensivecareunitpatientsaretrospectivestudy
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Effect of Therapeutic Plasma Exchange on Plasma Constituents in Neurointensive Care Unit Patients: A Retrospective Study

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