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Abstract
Introduction: Therapeutic plasma exchange is an extracorporeal blood purification technique. Centrifuge-based therapeutic plasma exchange (plasmacentrifugation) requires flows of 50 ml/min which allows the exchange with peripheral vascular accesses. The main objective of this study is to analyze the use and complications of peripheral vascular access in plasmacentrifugation sessions. Material and Method: Descriptive observational longitudinal study on the analysis of peripheral vascular access complications in plasmacentrifugtion sessions between January 2017 and March 2018. Results: A total of 93 plasmacentrifugation sessions were included. Sessions were carried out in 9 patients with a median of 7 [P25:6; P75:10.5] per patient. 66.66% (n=6) were women. Centrifugation was used in 89.24% (n=83) of the sessions and in 10.75% (n=10) photoaferesis. The etiologies of the disease for these patients were: renal in 55.55% (n=5) of cases, neurological in 33.33% (n=3) of cases and dermatological in 11.11% (n=1). There were problems related to the channeling of peripheral vascular access in 52.69% of the sessions (n= 49). Conclusions: Because in more than half of the sessions there were complications in the channeling of peripheral vascular access, it is concluded that ambulatory vascular study of the patient is necessary before the first session, the use of ultrasound guided puncture may be useful.
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References
- Madore F, Lazarus JM, Brady HR. Therapeutic Plasma Exchange in Renal Diseases. J. Am. Soc. Nephrol.1996;7:367-86.
- Anaya F. Por qué la aféresis terapéutica debe pertenecer a la especialidad de nefrología. Rev Nefrología.2011;31(4):379-81.
- Aznar Barbero S, Bel Cegarra R, Chica Arellano J. Resultados de intercambio plasmático en síndrome del hombre rígido: experiencia de un caso. Rev Enfermería Nefrológica.2014;17(3):216-21.
- Okafor C, Ward DM, Mokrzycki MH, Weinstein R, Clark P, Balogun RA. Introduction and overview of therapeutic apheresis. J Clin Apher.2010;25:240-9.
- Guillermo J, Pons E, Serrano R,Lozano M, Cid J, Cervera R, Espinosa G. Recambio plasmático en las enfermedades autoinmunes sistémicas. Sem Fund Esp Reumatol.2013;2(14):43-50.
- Golestaneh L, Mokrzycki MH. Vascular access in therapeutic apheresis: J Clin Apher.2013;28(1):64-72.
- Fortun J. Infecciones asociadas a dispositivos intravasculares utilizados para la terapia de infusión. Enferm Infecc Microbiol Clin.2008;3(26):168-74.
- Ipe T, Marques M. Vascular access for therapeutic plasma exchange. Transfusion.2018;1:580-9.
- Rodriguez-Calero MA, Blanco-Mavillard I. Dificultad en la canalización de vías periféricas: ¿existen factores de riesgo?. Evidentia. 2017;14,(1). Disponible en https://dialnet.unirioja.es/servlet/articulo?codigo=6376673.
- Sabri A, Szalas J, Holmes KS, Labib L, Mussivand T. Failed attempts and improvement strategies in peripheral intravenous catheterization. Biomed Mater Eng. 2013;23(1-2):93-108. [Consultado 5 diciembre 2018]. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/23442240.
- Egan G, Healy D, O’Neill H, Clarke-Moloney M, Grace P a, Walsh SR. Ultrasound guidance for difficult peripheral venous access: systematic review and meta-analysis. Emerg Med J. 2015;30(7):521–6. [Consultado 5 diciembre 2018]. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/22886890.
- Juvin P, Blarel A, Bruno F, Desmonts J-M. Is peripheral line placement more difficult in obese than in lean patients? Anesth Analg. 2003;96:1218, table of contents.
- Shaz BH, Schwart J and Winters JL. How we developed and use the American Society for Apheresis guidlines for therapeutic apheresis procedure. Transfusion. 2014;54:17-25.
- Malchesky PS, Koo AP, Skibinski CI, Hadsell AT, Rybicki LA. Apheresis technologies and clinical applications: the 2007 international apheresis registry. Ther Apher Dial. 2010;14(1):52-73.
- Hanafusa N, Noiri E, Nangaku M. Vascular access puncture under ultrasound guidance. Ther Apher Dial. 2014;18(2):213-4.
References
Madore F, Lazarus JM, Brady HR. Therapeutic Plasma Exchange in Renal Diseases. J. Am. Soc. Nephrol.1996;7:367-86.
Anaya F. Por qué la aféresis terapéutica debe pertenecer a la especialidad de nefrología. Rev Nefrología.2011;31(4):379-81.
Aznar Barbero S, Bel Cegarra R, Chica Arellano J. Resultados de intercambio plasmático en síndrome del hombre rígido: experiencia de un caso. Rev Enfermería Nefrológica.2014;17(3):216-21.
Okafor C, Ward DM, Mokrzycki MH, Weinstein R, Clark P, Balogun RA. Introduction and overview of therapeutic apheresis. J Clin Apher.2010;25:240-9.
Guillermo J, Pons E, Serrano R,Lozano M, Cid J, Cervera R, Espinosa G. Recambio plasmático en las enfermedades autoinmunes sistémicas. Sem Fund Esp Reumatol.2013;2(14):43-50.
Golestaneh L, Mokrzycki MH. Vascular access in therapeutic apheresis: J Clin Apher.2013;28(1):64-72.
Fortun J. Infecciones asociadas a dispositivos intravasculares utilizados para la terapia de infusión. Enferm Infecc Microbiol Clin.2008;3(26):168-74.
Ipe T, Marques M. Vascular access for therapeutic plasma exchange. Transfusion.2018;1:580-9.
Rodriguez-Calero MA, Blanco-Mavillard I. Dificultad en la canalización de vías periféricas: ¿existen factores de riesgo?. Evidentia. 2017;14,(1). Disponible en https://dialnet.unirioja.es/servlet/articulo?codigo=6376673.
Sabri A, Szalas J, Holmes KS, Labib L, Mussivand T. Failed attempts and improvement strategies in peripheral intravenous catheterization. Biomed Mater Eng. 2013;23(1-2):93-108. [Consultado 5 diciembre 2018]. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/23442240.
Egan G, Healy D, O’Neill H, Clarke-Moloney M, Grace P a, Walsh SR. Ultrasound guidance for difficult peripheral venous access: systematic review and meta-analysis. Emerg Med J. 2015;30(7):521–6. [Consultado 5 diciembre 2018]. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/22886890.
Juvin P, Blarel A, Bruno F, Desmonts J-M. Is peripheral line placement more difficult in obese than in lean patients? Anesth Analg. 2003;96:1218, table of contents.
Shaz BH, Schwart J and Winters JL. How we developed and use the American Society for Apheresis guidlines for therapeutic apheresis procedure. Transfusion. 2014;54:17-25.
Malchesky PS, Koo AP, Skibinski CI, Hadsell AT, Rybicki LA. Apheresis technologies and clinical applications: the 2007 international apheresis registry. Ther Apher Dial. 2010;14(1):52-73.
Hanafusa N, Noiri E, Nangaku M. Vascular access puncture under ultrasound guidance. Ther Apher Dial. 2014;18(2):213-4.