Plasmapheresis - CRRT Online

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Number of plasmaphereses needed Removal of IgM (Ward DM, Updates to Harrison’s Principle’s of Internal Medicine, Volume V, 1984) Removal of IgG (Ward DM, Updates to Harrison’s Principle’s of Internal Medicine, Volume V, 1984) Monoclonal IgM (mg/dl) IgG Autoantibody titer 5000 IgM 1:20,480 IgG 980 254 <strong>Plasmapheresis</strong> procedures • IgM is large (~970,000 Daltons) • 90% of IgM stays intravascular <strong>Plasmapheresis</strong> procedures Most antibody mediated diseases: • IgG is smaller (~146,000 Daltons) • Only 25%-30% is intravascular dmward@ucsd.edu
Distribution of body water Standard 70 Kg Adult Total body water (TBW) = 50% - 60% of weight, say 57% = 40 liters Total Body Intracellular Water 25 liters 40 liters Interstitial Extracellular 12 liters 15 liters Interstitial fluid (third space) = 25 - 30% of TBW, say 30% = 12 liters Intracellular fluid = 60 - 65% of TBW, say 62.5% = 25 liters Plasma 3 liters Extracellular fluid = 35 - 40% of TBW, say 37.5% = 15 liters Plasma ~8% = 3 liters dmward@ucsd.edu
Page 1 and 2: Workshop B02 Tuesday February 14 th
Page 3 and 4: WARNING: Many of the hybrid extraco
Page 5 and 6: Case reports Three patients at UCS
Page 7 and 8: Case reports Since 1992 at UCSD, C
Page 9 and 10: Case reports Plasmapheresis goal:
Page 11 and 12: Manual plasmapheresis PLASMA REMOVA
Page 13 and 14: Plasmapheresis applications Autoant
Page 15 and 16: Also see Indications for therapeuti
Page 17 and 18: Apheresis methods Manual Plasmapher
Page 19 and 20: Separation by centrifugation
Page 21 and 22: Separation by centrifugation Whole
Page 23 and 24: Separation by centrifugation Plasma
Page 25 and 26: Conventional Therapeutic Apheresis
Page 27 and 28: Intermittent plasmapheresis Prescri
Page 29: Number of plasmaphereses needed Rem
Page 33 and 34: Kinetics of intermittent clearance
Page 35 and 36: Anticoagulation Citrate: 1. Familia
Page 37 and 38: Intermittent plasmapheresis - choic
Page 39 and 40: Plasma regeneration (on-line purifi
Page 41 and 42: Cascade Plasmafiltration (Double-Fi
Page 43 and 44: Antibody Immunoadsorption with Anti
Page 45 and 46: Braun “HELP”® System (Heparin-
Page 47 and 48: Covalently-bound peptide ligands fo
Page 49 and 50: Current use of on-line plasma purif
Page 51 and 52: dmward@ucsd.edu “Resin” adsorpt
Page 53 and 54: Membrane plasmapheresis: from patie
Page 55 and 56: Intermittent Plasmapheresis + citra
Page 57 and 58: Continuous Plasmapheresis + citrate
Page 59 and 60: Continuous Plasmapheresis + CRRT IN
Page 61 and 62: Continuous Plasmapheresis + CRRT IN
Page 63 and 64: Double Filtration Plasmapheresis +

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