Plasmapheresis for hypertriglyceridemia: The association between blood viscosity and triglyceride clearance rate

Abstract

Objectives Several factors in double filtration plasmapheresis (DFPP) were associated with triglyceride (TG) clearance rate. This study examines whether baseline whole blood viscosity was a predictor for efficient TG removal. Methods Adult subjects who receiving DFPP for hyperlipidemia in Taoyuan General Hospital from January 2015 to March 2018 were classified into efficient and inefficient TG removal according to TG removal rate ≥50% vs <50%. TG removal rate was defined as following formula: (pre‐apheresis TG‐ post‐apheresis TG)/pre‐apheresis TG. Whole blood viscosity (WBV) was estimated by following equation: WBV = 0.12 × hematocrit +0.17 × (total protein −2.07). Univariate linear regression was used to assess the association between TG removal rate and WBV. Odds ratios (ORs) and 95% confidence interval (95%CI) for associations between variables and efficient TG removal were evaluated by logistic regression model to including univariate and multivariate adjustment. Results From a total of 66 subjects receiving DFPP, 37 subjects reached efficient TG removal. The difference in pre‐apheresis TG levels, hematocrit, and WBV between efficient vs. inefficient TG removal groups was 4.1 vs 6.7 mmol/L; 43.1% vs 39.5%; and 6.0cP vs 5.cP (Ps <0.05). After multivariate adjustment, WBC was a significant predictor for efficient TG removal (ORs and 95% CI were 3.192 (1.300‐7.838), P < 0.05). The correlation between WBV and extraction of TG was significant (r = −0.255, P = 0.039). Conclusion Hyperviscosity reduced the efficiency of TG removal in those receiving DFPP.

Membrane‐based therapeutic plasma exchange: Hemodynamics and operational characteristics leading to procedure failure

“…Although prior literature has demonstrated an increased tendency for pathologic thrombosis with increased weight, we hypothesize that our observation of increased filter failure may be related to increased total plasma volume that much pass through the filter. [6][7][8] As the plasma volume exchange prescription is based on total plasma volume, and plasma volume is in turn partially based upon a patient's weight, a larger patient would have an increased total volume of plasma needing removal across the filter membrane.…”

Is there any relationship between triglyceride and hemogram indicesin insulin resistance ?

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Sirolimus-Induced Severe Hypertriglyceridemia Presenting with Signs of Hyperviscosity Syndrome and as Pink Colored Blood: A Case Report

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