“…This may be attributed to the overall low incidence of bleeding events. Other centers reported similar or lower bleeding rates of 2.2% [27] 1.3% [19], 0.2% [18] and 0.06% [20] in TPE. There were 9 bleeding events in 722 IAS treatments, one of them requiring blood transfusion.…”
Background: Immunoadsorption (IAS) and therapeutic plasma exchange (TPE) are considered safe although fibrinogen is removed. To date no comparison of fibrinogen reduction and associated risk of bleeding in apheresis exists. Methods: Retrospective analysis of TPE, three IAS adsorbers, and combined TPE/IAS regarding fibrinogen reduction and bleeding incidence in 67 patients (1,032 treatments). Results: TPE and TPE/IAS reduced fibrinogen by 64 ± 11% and 58 ± 9%, leading to concentrations <100 mg/dl in 20 and 17% of treatments, respectively. IAS decreased fibrinogen less than TPE (26 ± 6%, p < 0.0001), resulting in fibrinogen concentrations <100 mg/dl in 1% of treatments. The processed volume correlated with reduction in TPE (r = 0.64, p < 0.01), but not in IAS. Bleeding occurred in 1.3% (IAS), 2.3% (TPE) and 3.1% (TPE/IAS) of treatments. Conclusion: Hypofibrinogenemia occurs in 20% of patients after TPE and TPE/IAS, but rarely after IAS. IAS removes fibrinogen independently of volume processed. Overall, bleeding is rare in apheresis.
“…This may be attributed to the overall low incidence of bleeding events. Other centers reported similar or lower bleeding rates of 2.2% [27] 1.3% [19], 0.2% [18] and 0.06% [20] in TPE. There were 9 bleeding events in 722 IAS treatments, one of them requiring blood transfusion.…”
Background: Immunoadsorption (IAS) and therapeutic plasma exchange (TPE) are considered safe although fibrinogen is removed. To date no comparison of fibrinogen reduction and associated risk of bleeding in apheresis exists. Methods: Retrospective analysis of TPE, three IAS adsorbers, and combined TPE/IAS regarding fibrinogen reduction and bleeding incidence in 67 patients (1,032 treatments). Results: TPE and TPE/IAS reduced fibrinogen by 64 ± 11% and 58 ± 9%, leading to concentrations <100 mg/dl in 20 and 17% of treatments, respectively. IAS decreased fibrinogen less than TPE (26 ± 6%, p < 0.0001), resulting in fibrinogen concentrations <100 mg/dl in 1% of treatments. The processed volume correlated with reduction in TPE (r = 0.64, p < 0.01), but not in IAS. Bleeding occurred in 1.3% (IAS), 2.3% (TPE) and 3.1% (TPE/IAS) of treatments. Conclusion: Hypofibrinogenemia occurs in 20% of patients after TPE and TPE/IAS, but rarely after IAS. IAS removes fibrinogen independently of volume processed. Overall, bleeding is rare in apheresis.
“…Data were presented at the Symposium on Therapeutic Apheresis Bad Oeynhausen October 2012 and were already published elsewhere [10]. Table 1 shows the demographic data as well as the cardiocirculatory risk factors.…”
Section: Resultsmentioning
confidence: 99%
“…The mean increase over all the patients and frequencies was 14.9 ± 2.7 dB.Fig. 2The remission rates divided into different frequencies of hearing loss [10]Fig. 3The hearing thresholds before and after fibrinogen/LDL apheresis in percent [10]…”
BackgroundFibrinogen/LDL apheresis has been proven to be effective in treatment of sudden sensorineural hearing loss (SSNH). This study is aimed to investigate if reduction of fibrinogen and serum LDL is also effective in patients with SSNH non-responding toward treatment with corticosteroids and plasmaexpanders.MethodsRemission rates of 217 patients suffering from SSHL were investigated after treatment with apheresis. All patients were non-responders after other therapies such as high doses of steroids or plasmaexpanders.ResultsSingle apheresis resulted in complete or partial remissions in 61% of patients when given after other unsuccessful conducted therapies such as corticosteroids and plasmaexpanders.ConclusionFibrinogen/LDL apheresis is a promising rescue therapy for sudden sensorineural hearing loss even after unsuccessful other therapies.
“…However, their test group was on average 15 years older than the control group, which may have influenced the results. In addition, it is suggested that fibrinogen/LDL apheresis may improve cochlear blood flow by acutely decreasing plasma cholesterol and fibrinogen [11,12]. However, it is hard to say whether the therapeutic effect is gained from lowing fibrinogen or LDL.…”
BackgroundPathological levels of blood lipids could be one of the causes of sudden sensorineural hearing loss (SSNHL). The objective of this manuscript is therefore to evaluate the relationship between blood lipid content and sudden sensorineural hearing loss (SSNHL).MethodsThe correlation between serum lipid parameters, including total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein AI (apo AI), apolipoprotein B (apo B), and lipoprotein A (Lp(a)), and the onset of SSNHL was analyzed from a data set of 250 patients and an age, gender and weight matched control group of 250 subjects.ResultsThe result of single factor logistic regression shows that TC (p<0.01), LDL-C (p<0.01), and apo B (p=0.03) of SSNHL group were significantly higher than those of the control group. The odds ratio of TC, LDL, and apo B are higher than 1, while the confidence intervals of the odds rations do not include 1. No significant difference was found with the prevalence of hypertension (P=0.818), diabetes (P=0.869) and smoking habits (P=0.653) between SSNHL group and control group.ConclusionTotal cholesterol, low density lipoprotein cholesterol and apolipoprotein B concentrations may be important factors in the pathogenesis of sudden sensorineural hearing loss, and should be assessed during the investigation of patients with this condition.
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