Therapeutic Plasma Exchange copy

17
Dr. Nippun Prinja

Transcript of Therapeutic Plasma Exchange copy

Page 1: Therapeutic Plasma Exchange   copy

Dr. Nippun Prinja

Page 2: Therapeutic Plasma Exchange   copy

Plasmapheresis Plasma exchange

Page 3: Therapeutic Plasma Exchange   copy

TPE Healthy Donors Plasma Exchange

Page 4: Therapeutic Plasma Exchange   copy

Crystalloids Colloids Plasma Protein Fraction FFP

Page 5: Therapeutic Plasma Exchange   copy

Removal Of Antibodies Removal Of Immune Complexes Hyperviscosity Syndromes Removal Of toxins Replacement Of Deficient Plasma

Components

Page 6: Therapeutic Plasma Exchange   copy

1=standard& acceptable 2=generally accepted 3=case studies 4=lacking efficacy P=phase 3 pharma trials

Page 7: Therapeutic Plasma Exchange   copy

Manual-by use of plastic bag Automated-by cell separator machines

Page 8: Therapeutic Plasma Exchange   copy

Reaction to replacement fluids Vasovagal reactions Pyrogenic reactions Hypocalcemia Haemolytic transfusion reactions.

Page 9: Therapeutic Plasma Exchange   copy

THERAPEUTIC LEUCAPHERESIS THERAPEUTIC THROMBOPHERESIS THERAPEUTIC ERYTHROPHERESIS

Page 10: Therapeutic Plasma Exchange   copy

MANUAL APHERESIS MACHINE

Page 11: Therapeutic Plasma Exchange   copy

INTERMITTENT FLOW CENTRIFUGATION. CONTINUOUS FLOW CENTRIFUGATION.

Page 12: Therapeutic Plasma Exchange   copy

Haemonetics Density=redcells>white

cells>platelets>plasma Seprated components from bowl through

outlet port into seprated bag Centrifuge stops and pump get reversed Components not required returned to

individual 6-8 cycles are done till desired quality &

quantity

Page 13: Therapeutic Plasma Exchange   copy
Page 14: Therapeutic Plasma Exchange   copy

COMTEC,AMICUS. Blood is withdrawn,processed and returned

to the individual simultaneously. Earlier two venous access,now one. Advantage of speed,small extra corporeal

volume. Isovolumeic status of donor is maintained

minimizing fluid loss.

Page 15: Therapeutic Plasma Exchange   copy
Page 16: Therapeutic Plasma Exchange   copy
Page 17: Therapeutic Plasma Exchange   copy

ICU Well trained staff First aid kit Written consent Adverse effects/reaction Availability of physician if complication