REPLACEMENT FLUIDS IN PLASMAPHERESIS - CROSS-OVER COMPARATIVE-STUDY

Objective:To compare the tolerance and the cost of three replacement f luids in plasmapheresis: albumin 4 % alone, albumin 4 % + dextran 40, or albumin 4 % + hydroxyethylstarch 6 %. Design: A one center randomiz ed, cross-over, comparative study designed to explore the tolerance an d the colloid oncotic pressure in patients undergoing plasmapheresis. Patients: 225 plasmapheresis procedures were performed in 27 patients. Measurements and results: Hemodynamic tolerance was good in the three treatment groups. Serum protein concentration after plasmapheresis wa s significantly lower in the albumin + hydroxyethylstarch group, follo wed by albumin + dextran 40, versus albumin alone. Colloid oncotic pre ssure before and after exchange was similar in the three groups. Concl usions: The clinical use of 25-30 % of hydroxyethylstarch 6 % or dextr an 40 with albumin 4 % was clinically well tolerated and associated wi th a 12 % decrease of the cost of substitution solutions.