Potential Danger Of Thrombosis After Plasma Exchange In The Treatment Of Patients With Immune Disease
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Transfusion: indications (RBC, platelets, granulocytes, plasma)
prophylactic plasma transfusions to patients with normal coagulation tests submitted to high-risk surgery or invasive diagnostic procedures. volume expansion (in spite of being a good volume expander; we have colloids and cristalloids for that !) plasma exchange: use albumin or crystalloids !
Update in Immune Axonal Neuropathies
25% patients deteriorate during/shortly after treatment with IVIg or PE 10% patients relapse ( Treatment-Related Fluctuation [TRF]) 5% Mortality ~20% GBS patients cannot walk unaided 6 months after onset Most have residual pain and fatigue Most improvement happens in the first year, but some show further recovery
guillain barre syndrome - LITFL
additional benefit is conferred by combined treatment - patients with heart disease, renal insufficiency, hyperviscosity or IgA deficiency may be more susceptable to the complications of IVIG whereas labile BP, septicaemia and venous access problems may preclude plasma exchange (i) plasma exchange: