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Ebook Manual of extracorporeal membrane oxygenation (ECMO) in the ICU: Part 2

(BQ) Part 2 book “Manual of extracorporeal membrane oxygenation (ECMO) in the ICU” has contents: Plasmapheresis, extracorporeal membrane oxygenation in pediatric patients with respiratory failure, echocardiographic imaging of patients on extracorporeal membrane oxygenation, pathophysiology of heart failure, and other contents. | 24 Plasmapheresis Venkat Goyal, Pranay Oza CHAPTER OUTLINE Modalities of Apheresis Cytapheresis Erythrocytapheresis Leukapheresis Plateletpheresis It is derived from the Greek verb "apheresis" meaning "to take away, withdraw or separate". Apheresis is a process of removing, replacing or depleting unique circulating substances that are responsible for the disease process. Apheresis is also being done in blood bank to separate different components of blood for transfusion. Therapeutic plasma exchange (TPE) is the most frequent "apheresis" modality performed. Modem TPE was introduced by Abel and Roundtree in 1914. They treated toxemia in an animal model by removing plasma and returning cellular components. In 1959, Skoog and Adams and in 1963, Solomon and Fabey, first used plasma exchange in the treatment of hyperviscocity syndromes such as macroglobulinemia. MODALITIES OF APHERESIS Apheresis can basically classify into 2 types—cytapheresis and plasmapheresis or therapeutic plasma exchange (TPE) depending on the component one wants to remove. Cytapheresis is a process of removing cellular components and TPE is removal of specified plasma volume. CYTAPHERESIS Cytapheresis includes red cell apheresis or erythrocyta­ pheresis, leukapheresis and plateletpheresis. Cytapheresis can be used for component transfusion or can be used for therapeutic purpose to remove abnormal cells. Therapeutic indications of cytapheresis are given in Table 1. Plasmapheresis or Therapeutic Plasma Exchange Indications of Plasmapheresis Principles of Apheresis and Therapeutic Plasma Exchange Treatment and Precautions Complications ERYTHROCYTAPHERESIS It is the process of removal of red blood cells (RBCs) and the return of replacement fluids most commonly donor's RBC (leukocyte depleted). It is also known as red blood cell exchange (RBCX). It corrects anemia, polycythemia and blood viscosity. It improyes tissue oxygenation as well as pulmonary compliance.