連続的へマトクリットモニター(CLM^<TM>)を用いた二重濾過血漿分離交換法施行時の低血圧予防と置換液(量・アルブミン濃度)の設定(<特集>肝・膵疾患とアフェレシス)

概要

論文の詳細を見る
A continuous hematocrit monitor, CLIT-LINET^<TM>, was introduced to examine the change of patient's blood volume due to albumin loss during double-filtration plasmapheresis (DFPP)treatments. Nineteen patients with auto-immune diseases or ABO incompatible renal transplantation received 52 DFPP treatments under CLIT-LINET^<TM>monitoring. In a patient, the value for corrected concentration of serum albumin(C_<alb>)changes from 4.9 g/dl to 2.9 during the treatment. This means albumin loss occurred in the treatment. Corrected C_<alb> value at post- treatment should be used because of the patient's blood condensation during the treatment. A decrease in patient's blood volume is supposed to be induced by oncotic pressure drop due to albumin loss, and often results in blood pressure drop and interuption of the treatment. The amount of albumin loss during DFPP treatments was strongly correlated with pre-treatment C_<alb> and albumin concentration(C_s)and volume(V_s)of the supplementation fluid. Optimum C_s and V_s values should be determined by the continuous monitoring of blood volume using CLIT-LINET^<TM>to avoid blood pressure drop during treatment.
日本アフェレシス学会の論文
1997-10-31