Membrane Plasma Exchange by Single-Needle Hemofiltration Device. A Technical Note

Wilms, Heinz; Keller, Frieder; Offermann, G.

doi:10.1177/039139888400700417

Cited by 3 publications

(1 citation statement)

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“…With each treatment, 4,000 ml of plasma were exchanged with a filtration rate (Qf) of 50-80 ml/min within 1-2 h using a mod ified hemofiltration device as described previously [3], Hemoperfusion was performed using a charcoal cartridge (Haemosorba, Braun. Melsungen) sepa rately or in combination with hemodialysis.…”

Section: Methodsmentioning

confidence: 99%

Plasma Exchange and Hemoperfusion in Iodine-Induced Thyrotoxicosis

Preuschof¹,

Keller²,

Bogner

et al. 1991

Blood Purif

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Iodine-induced thyrotoxicosis is a life-threatening disease. Plasma exchange and hemoperfusion are the available means of detoxication. Both methods were applied repeatedly to 4 patients with iodine-induced thyrotoxicosis, and the efficacy of these treatment methods was compared. Thyroxine plasma levels were decreased by 33%, while the calculated body stores were reduced by 18 % during plasma exchange. Hemoperfusion was less effective. With both methods, a rebound of plasma levels was seen. Improvement of the clinical condition was delayed for 1 week after discontinuation of treatment. One patient died, probably because detoxication was discontinued too soon after the thyroid hormone levels had normalized. Plasma exchange by using albumin (120 g/4,000ml = 30 g/l) as replacement fluid is superior to that by using fresh-frozen plasma (2,000 ml/4,000 ml), since less thyroxine is administered (19 vs. 160 nmol).

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Section: Methodsmentioning

confidence: 99%

Plasma Exchange and Hemoperfusion in Iodine-Induced Thyrotoxicosis

Preuschof¹,

Keller²,

Bogner

et al. 1991

Blood Purif

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Single Needle Haemodialysis

Vanholder¹,

Hoenich²,

Ringoir³

1989

Replacement of Renal Function by Dialysis

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Effect of Plasma Exchange on the Steady-State Kinetics of Digoxin and Digitoxin

Keller

Kreutz

Vöhringer

et al. 1985

Clinical Pharmacokinetics

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The pharmacokinetic effect of extracorporeal elimination can be evaluated from the extracorporeal elimination rate constant, from the amount of drug removed, and from extracorporeal clearance. To compare the validity of these approaches in clinical practice, the effect of multiple plasma exchanges on the steady-state kinetics of digoxin (5 patients) and digitoxin (9) was investigated. For digoxin, an unchanged elimination half-life (28 hours) and only slight increase in the total body clearance was found (from 203 to 204 ml/min). There was a more pronounced effect on the kinetics of digitoxin, where the elimination half-life decreased from 4.3 to 3.6 days, and the total body clearance increased from 4.4 to 4.7 ml/min. For digoxin there was no statistically significant difference between observed and predicted steady-state trough plasma concentrations. For digitoxin, the observed trough plasma concentrations at steady-state correlated well (p less than 0.05) with the predicted concentrations calculated from the amount removed or from extracorporeal clearance. The magnitude of the kinetic effect of plasma exchange is overestimated using the extracorporeal elimination rate constant; but the effect of extracorporeal elimination can be adequately evaluated from the amount of drug removed and from extracorporeal clearance. These later approaches can be considered model-independent. Thus, the influence of multiple plasma exchanges on the steady-state kinetics of digoxin and digitoxin will be limited and dosage adjustment is not required, if these drugs are given after - not before - the procedure and hypoalbuminaemia is corrected.

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Membrane Plasma Exchange by Single-Needle Hemofiltration Device. A Technical Note

Cited by 3 publications

References 1 publication

Plasma Exchange and Hemoperfusion in Iodine-Induced Thyrotoxicosis

Plasma Exchange and Hemoperfusion in Iodine-Induced Thyrotoxicosis

Single Needle Haemodialysis

Effect of Plasma Exchange on the Steady-State Kinetics of Digoxin and Digitoxin

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