Prima experiența de plasmafereza automată in institut de cardiologie

Abstract

The purpose of the study: to investigate the results of the first experience in the Cardiology Institute of curative plasmapheresis Material and methods: procedural records were studied for 30 sessions of automatic plasmapheresis with the DigiPla 80 device for 10 patients admitted to the Institute of Cardiology from December 4, 2022 to June 23, 2023, the disease records of these patients were evaluated, with the analysis of the indications for plasmapheresis, the results post-procedural analyses, condition at discharge from the hospital. Results: 9 cardiac patients with a secondary diagnosis of allergy to various agents (cold, insects, drugs, food, etc.) were subjected to the standard procedure of automatic plasmapheresis with the removal of 800 ml of autoplasma at each session, with the replacement with crystalloid solutions one by one, with the obvious improvement of both allergic symptoms (disappearance of skin exanthema, disappearance of itching, hyperemia, etc.), as well as cardiac symptoms), in one patient the rhythm was converted from atrial fibrillation to sinus rhythm without cardiac remedies). Lipothymia was experienced by 2 patients in 2 sessions with a positive evolution, the return of normal hemodynamics, they did not lose consciousness. A patient died, his plasmapheresis was performed on vital indications, being in extremely serious condition before the plasmapheresis session, the cause of death is closely related to heart failure with cardiogenic shock, with pump deficiency. Conclusions: the first results are encouraging for the treatment of cardiac patients with allergic symptoms. Studying the medical records, accumulating procedural experience will allow expanding the curative plasmapheresis indications.

Scopul studiului: de a cerceta rezultate primei experientei in Institut de Cardiologie a plasmaferezei curative Material si metode: au fost studiate fișe procedurale la 30 ședințe de plasmafereza automata cu aparatul DigiPla 80 la 10 pacienti internati in Institut de Cardiologie din 4 decembrie 2022 pana 23 iunie 2023, evaluate fișe de boala acestor pacienti, cu analiza indicațiilor pentru plasmafereza, rezultatelor analizelor postprocedurale, starii la externare din spital. Rezultate: 9 pacienti cardiaci cu diagnostic secundar alergie la diferite agenti (frig , insecte , medicamente, alimentație ,etc) au fost supusi procedurii standarte de plasmafereza automata cu eliminare 800 ml de autoplasma la fiecare ședinta, cu inlocuirea cu solutii cristaloide unu la una, cu imbunatațirea vadita a simptomatologiei atat alergice ( dispariția exantemului pielei , dispariția pruritului ,hiperemiei, etc), cat și simptoamelor cardiace ), la o pacienta sa convertit ritmul din fibrilatie atriala in ritm sinusal fara remedii cardiace). Stare de lipotimie a avut 2 pacienți la 2 ședințe cu evoluția pozitivă, revenirea hemodinamicii normale , cunoștința ei nu au pierdut. A decedat un pacient, plasmafereza lui a fost efectuata pe indicatii vitale , fiind in stare extrem de grava inainte de efectuare ședinței de plasmafereza, cauza de deces este strans legata cu insuficienta cardiaca cu șoc cardiogen,cu deficit de pompa. Concluzii: primele rezultate sunt incurajatoare pentru tratarea pacientilor cardiaci cu simptomatologie alergica. Studierea fișelor de boala , acumularea experienței procedurale va permite largirea indicațiilor de plasmafereza curative.