Plasmapheres - what is the procedure and when it is necessary. What is plasmophoresis, what diseases treats, the cost of the procedure is accompanied with plasmferresis procedure for

The date: 21.10.2019

Plasmapheres - A procedure that is aimed at purifying blood from various substances. It is referred to as elecorporal methods of hemocorrection, that is, to such, in which blood is extracted from the body, purified, and then returned back to the vessels. At plasmapheresis, blood is separated on the plasma (liquid part) and uniform elements (blood cells: erythrocytes, leukocytes, platelets). The plasma is removed, and the shaped elements are diluted with special blood resources and return back.

It can be believed that the first type of Plasmapheresis was still bleeding, which was practiced by the ancient Greeks, and then doctors of European countries. This procedure also was intended to remove toxins together with blood. At the same time, before the emergence of special technologies, the body lost not only the plasma, but also all cells circulating in it.

Features of the structure and value of blood in the body

Blood is often called the inner medium of the body. It is washes all organs and tissues, contacts almost every cell of the body.

The composition of blood includes a liquid part - plasma, - and uniform elements, or blood cells: erythrocytes, leukocytes, platelets. The plasma dissolves various substances: proteins, antibodies, fats, sugar, hormones, enzymes, taking part in coagulation.

Basic blood functions in the body:

Transfer of oxygen from the lungs to all organism cells and reverse carbon dioxide (respiratory provision).
Transport of nutrients suction in the intestine from food.
Transport of enzymes and hormones.
Maintaining a permanent equilibrium in the organism - homeostasis. Blood has permanent acidity, osmotic pressure.
Ensuring immune protection: blood cells are isolated antibodies and biologically active substances that provide protection from alien agents.
Isolation of toxic substances and currency exchange products.
Delivery of toxic substances in the liver for their disposal.

Thus, blood as it would bind the entire body into a single whole. It reacts to pathological processes that occur in any organ. At the same time, substances that are circulated in the blood have an impact on the whole organism.

Different substances can be in blood in two types.:

inside or on the surface of blood cells: for example, oxygen and carbon dioxide that transfers blood flows are associated with hemoglobin in red blood cells;
in a dissolved plasma state: This is the transport of most substances.

Normally, toxic substances and exchange products are removed from the blood flow using liver and kidney. But with various diseases and pathological conditions, these bodies cease to cope normally with their functions. In such cases, plasmapheresis is applied.

In which areas of medicine use Plasmapheresis?

Depending on the appointment, there are two types of plasmapheres:

Donor - Exercised at blood transfusion stations. The donor plasma containing nutrients is then transfused to recipients. It can be stored for a long time in frozen and canned form.
Therapeutic - It is used to purify blood at various diseases.

Scope of the Therapeutic Plasmapheresis:

Cardiology: chronic heart disease and vessels.
Neurology: Chronic diseases of the nervous system.
Gynecology: Chronic diseases of the women's reproductive system.
Endocrinology: Violations of the functions of the glands of the internal secretion.
Pulmonology: Chronic respiratory diseases.
Nephrology: chronic diseases of the kidneys and urinary organs.
Narcology: Incitization of the body alcohol, narcotic substances.

Types of Plasmalisa

There are various methods with which the blood can be separated on the liquid and cellular part. Each of them has its own advantages and disadvantages.

Bezing Plasmapheres

These are the simplest blood purification techniques at which special equipment is not used. Today they are applied relatively rarely, as an alternative to more complex hardware methods.

Methods of Bezperaparazaeza:

Gravitational Plasmapheresis. As it follows from the name, the separation of blood occurs under the action of gravity force. The blood from the patient's veins enters the tube into the plastic bag, where the cells gradually settle, and the plasma remains on the surface. This method is the easiest and cheapest. But it allows you to clean small blood volumes, implies the great importance of the human factor and the risk of infection.
Frontal filtration plasmapheres. It is a kind of gravitational plasmapheresis. At the same time, blood elements are also lowered to the bottom of the plastic capacity, but on their path there is a special membrane that skips only the liquid and the molecules dissolved in it. This method, as well as the usual gravitational plasmapheresis, is simple and inexpensive, but allows you to process large blood volumes.

Hardware Plasmapheresis

These methods of Plasmapheresis suggest the use of special equipment.

Centrifuge Plasmapheres

When using this technique, the patient's blood is placed in a centrifuge that rotates at high speed. As a result of the fact that the liquid part and cells of the blood acquire different acceleration, they are separated from each other.

There are two types of centrifuge plasmapheresis:

Manual. At first, the blood of the patient is collected into a special sterile plastic bag. Then it is placed in the centrifuge.

Auto. The blood of the patient through the tube immediately enters the centrifuge, where it is separated on the liquid part and the cell. The latter immediately mixed with blood substitutes and returned to the patient's vessels. The advantages of this method are: a large number of settings and minimizing the human factor. But for automatic centrifuge plasmanesis, special equipment needs special equipment.

Filtration (membrane) Hardware Plasmapheresis

In this case, the patient's blood passes through the membrane, but this is done using special devices that use a pump that makes pendulum movements.

Apparatus for membrane plasmapheresis make it possible to purify a large amount of blood. It provides high quality cleaning. The rest of the method has the same advantages that automatic centrifuge plasmapheresis.

Cascade Plasmapheres

Cascade Plasmapheres It is a kind of filtration plasmapheresis, in which blood is passed through the membranes twice. The first membrane delays cell circulating in blood, but misses all molecules. The second delays large molecules, but it misses small. It happens in some diseases.

Basic Indications for Cascade Plasmapheresa:

Heavy flow atherosclerosisin which there is a damage to the heart and large vessels.
Heavy autoimmune diseases.
Heavy blood illness: Macroglobulinemia (a disease in which a pathological protein is formed, an increase in blood viscosity and leading to some other disorders), paraproteinemia (violation of the protein composition of blood), a thrombocytopenic purple (a disease in which blood coagulation is broken), myeloma disease (blood cancer type).
Hemolytic-uremic syndrome: The disease in which anemia develops as a result of the massive death of erythrocytes, a violation of blood coagulation, a violation of the kidney function.
Autoimmune diseases: Systemic red lupus, systemic sclerodermia, rheumatoid arthritis.
Chronic autoimmune bowel diseases:ulsenny nonspecific colitis, Crohn's disease.
Chronic severe diseases of the nervous system:chronic inflammatory polyneuropathy, Guillana Barre syndrome, malignant myasthenia, sclerosis.
Heavy chronic skin diseases: Epidermal toxic necroliz, buggy pemphigoid, bubble.
Status after transplantation To prevent autoimmune response to transplanted organs.

Cryophersopheres

During cryoplasmferresis, the patient's filtered plasma is frozen at -30⁰c. Then, during the next procedure, it is heated to + 4⁰c and repeatedly subjected to centrifugation.

After removing the plasma sediment, you can pour the patient again. The advantage of this method is that the patient's body practically does not lose protein. Disadvantage: The technique is quite inaccurate.

How is Plasmapheresis procedure?

Plasmapheresis equates to surgical interference, as well as transfusion, and other blood purification methods. The session on average may continue 1 - 2 hours, depending on the method of plasmapheresis and blood volume, which must be cleaned.

The patient is placed on a special chair or on a couch. To obtain blood, veins are usually used, which are under the skin at the location of the elbow bend. The doctor can introduce a needle into one vein (when using advancement and manual hardware techniques) or two, on the right and left hand (when using automatic hardware techniques, when blood is taken through one needle and simultaneously returned through the other).

Usually, a special catheter is installed in Vienna - Flex. It can be easily glued to the leafoplasty skin and introduce into it through a special extra opening of heparin - a drug that suppresses blood coagulation, prevents the formation of blood clots, the clogging of the catheter.

Sometimes, especially if the patient is in serious condition, the doctor cannot enter the needle and catheter into the elbow vein. In this case, the catheterization of the subclavian vein is performed. This is a more complex procedure, it can give great complications, and yet in some cases it has to be resorted to.

What blood reserves dilute blood cells after they are filtered from plasma?

Name of solution	Description
Saline	Sodium chloride solution - conventional salt, which is normal dissolved in blood at a concentration of 0.9%. The saline has the same osmolarity as biological fluids.
Glucose and potassium chloride solution	Potassium is the main ion that is present inside the cells. It provides the maintenance of the normal form and function of the cell, normalizes the work of the heart, nervous tissue. Glucose provides osmotic blood pressure and is a source of energy for cells.
Reopolyiglyukin	The composition of the solution of Reopolyglyukin: Dextran is a chain of glucose molecules. Saline. Reopolylukin reduces blood viscosity and restores normal blood flow in small vessels.
Donor or placental albumin	Albumin - the main protein, which is included in the blood. Placenta and donor albumin is an effective blood substitute.
Donor plasma	The liquid part of the blood obtained from the donor. It is mainly used in cases where the patient in the blood does not have enough substances responsible for the coagulation processes.

Indications for the use of Plasmapheresis

Group Diseases	Diseases
Heart disease and vessels	heart lesions in allergic and autoimmune diseases; viral damage to the heart muscle (viral myocarditis); complications of heart attack; inflammation of the heart of autoimmune origin; atherosclerosis; systemic vasculites are a group of diseases in which inflammation occurs in the walls of the vessels at the expense of autoimmune reactions.
Diseases of the respiratory organs	vegener granulomatosis - a disease in which the lung vessels is defeated; fiber viewing alveolitis - a disease in which autoimmune inflammation is developing in the lungs, breathing is disturbed; gemosiderosis is a disease in which the solid decay of erythrocytes occurs, and the resulting substances are circulated in the blood and are deposited in the lungs.
Diseases of digestive organs	non-specific ulcerative colitis - a disease, accompanied by chronic inflammation of the wall of the thick bowel with the formation of an ulcer; crohn's disease is chronic autoimmune intestinal inflammation; setton stomatitis - severe allergic inflammation of the mucous membrane of the oral cavity.
Diseases of the liver	chronic autoimmune liver inflammation; the lesion of the brain toxic substances that are allocated and are in the bloodstream in the diseases of the liver.
Diseases of the Bind of Internal Secretion	diabetes mellitus and its complications (the defeat of the blood vessels, kidneys, brain, legs); increased insulin sensitivity; asson's disease is an insufficient function of the adrenal cortex.
Skin disease	pemphigus; damage to the joints in psoriasis; heavy allergic reactions: swelling of quinics, urticaria; toxicodermia.
System Diseases of Connective Tissue	rheumatoid arthritis; system red lupus; dermatomyomy; systemic sclerodermia.
Eye diseases	eye damage for diseases of the internal secretion; inflammation of the vascular shell of the eye (this disease often leads to a decrease in vision and full blindness); chronic inflammation of the orbit; defeat of the vessels of the eyeball with diabetes mellitus.
Allergic diseases	atopic dermatitis - allergic skin damage; polynosis is an allergic reaction that occurs in a certain season and manifests in the form of a cold, tear; allergic reactions to various substances; allergic reactions to physical factors: solar rays, heat, cold, etc.
Diseases of kidneys	glomerulonephritis (renal tissue inflammation) autoimmune origin; inflammation of the kidneys with a systemic red lupus; gudpaschura syndrome is a disease in which the defeat of small kidney vessels occurs; severe kidney and ureteral infections; heavy breach of the kidney function.
Diseases of the nervous system	multiple sclerosis; chronic infectious diseases of the nervous system; allergic inflammation of brain tissue
Organism poisoning and reaction to various substances	alcoholism, ethyl alcohol poisoning, hanging syndrome; severe poisoning by some substances in everyday life and in production; reaction to all medicinal preparations; drug addiction, toxication.

There are only about 200 diseases in total, for the treatment of which plasmapheresis is applied. It is rarely used separately: as a rule, it is combined with other techniques.

There are absolute (when it is impossible to do without procedure) and relative (when the procedure is not fulfilled in all cases) indications for plasmapheresis. The decision is made by the attending physician.

During plasmapheresis from blood remove:

Immune complexes. These are the compounds of antibodies with antigens that settle on organs of organs, leading to their defeat. They are formed by immune cells during autoimmune diseases.
Erythrocyte decay products. In case of massive decay of erythrocytes, which occurs in certain diseases, substances are formed that can affect the cells of the brain, lungs, hearts. They should neutralize the liver, but with a lot of quantities it ceases to cope with its functions.
Toxic metabolic products. Usually they are removed by the kidneys with urine. But with certain diseases, they are formed so much that the need arises to bring them artificially. In case of diseases accompanied by a disorder of the kidney function, the withdrawal of toxic substances from the body is broken.
Toxic substances generated by cells of malignant tumors.
Toxins of bacteria and viruses.
Toxic substances entering the body from outside. For example, alcohol.
Cholesterol. Plasmapheresis is widely used in atherosclerosis.

Complications of Plasmalisa

Allergic reactions. They can develop in response to the introduction into the organism of donor plasma and plasma substitutes contained in a frozen plasma of preservatives, drugs that prevent blood coagulation. Manifest in the form of rash on the skin, chills, fever.
Anaphylactic shock. This is a severe allergic reaction, which is manifested by a violation of consciousness, falling blood pressure, impaired heart.
Citato poisoning - Substance that is used to reduce blood coagulation and preventing the formation of thrombus during the procedure. In this case, there is numbness in different parts of the body, muscle cramps.
Falling blood pressure. This can occur when a patient take a large amount of blood for cleaning.
Violation of kidney function. It occurs at autoimmune reactions during plasmapheresis, the incompatibility of the blood recipient with donor plasma.
Fit infection in the blood and development of sepsis ("Blood infection"). This is usually due to violation of the aseptic rules.
HIV infection. Today one-time tools are applied, therefore the probability of a human immunodeficiency virus is almost equal to zero.
Bleeding. In the overdose of funds used to reduce blood clotting, hemorrhages under the skin or in internal organs can be formed. Especially high risks, if the patient has stomach and intestines ulcers.
Thrombose. If funds that reduce blood clotting are applied in insufficient quantity, then thrombus are formed in a catheter or next to it on the wall of the vessel. A piece of thrombus can break away and get into the bloodstream - this is called thromboembolia. Especially dangerous thromboembolism of the pulmonary artery - when the thrombus falls into one of the blood vessels carrying blood into the lungs, and clogs his lumen. This is fraught with severe complications.

Contraindications for Plasmapheresis

Absolute contraindications to Plasmapheresis (Contraindications under which the procedure cannot be carried out in no case):

severe brain lesions;
heavy bleeding.

Relative Contraindications for Plasmapheresis (Contraindications that can be neglected):

Increased bleeding, Blood coagulation disorders. During plasmapheresis, the means to reduce blood clotting so that the catheter installed in Vienna does not borrow with blood closures. This can lead to strengthening bleeding.
Stomach and intestinesunder which there is a high risk of bleeding. After the procedure, they can give severe bleeding.
Low blood pressure. During plasmapheresis, a patient pumps a certain amount of blood for a while. This is capable of deteriorating the state of the cardiovascular system.
Cardiac arrhythmias. Reducing the amount of blood and decrease in blood pressure affect the function of the heart. Arrhythmia can enhance, lead to serious disorders that threaten the life of the patient.
Low protein content in blood plasma. During plasmanesis, together with the plasma, the body loses proteins that perform many important functions.
Acute infections. Any infectious process is a certain load on the heart and vessels. Microorganisms or their toxins penetrate the bloodstream and circulate in it.
Monthly women. During menstruation, blood loss occurs.

What survey is carried out before plasmapheresis procedure?

Research name	Description	How to run
General blood analysis	Generalization study that helps to estimate the content of various cells in the blood (red blood cells, leukocytes, platelets), hemoglobin, erythrocyte sedimentation rate.	For general analysis take a small amount of blood from the finger or from the vein.
Coagulogram and analysis for blood coagulation	These studies help assess the condition of the blood coagulation system, reveal an increased bleeding or, on the contrary, a tendency to thrombosis.	For research take blood from Vienna. Before studying the patient should not take medicines affecting blood clotting.
RW Blood (Vasserman Reaction)	The Vasserman reaction is a standard study that helps to identify syphilis. This analysis is carried out in all adults coming to treatment.	Blood for research takes from Vienna.
Blood study on glucose	It is carried out in patients with diabetes. Helps to identify elevated blood sugar levels.
Study of the level of proteins in the blood	The study helps to identify changes in the protein composition of blood. Low protein content may be a contraindication to plasmapheresis.	For research take blood from Vienna on an empty stomach.
Measuring blood pressure	It is carried out using a tonometer. With low arterial pressure indicators, the doctor may postpone or cancel the procedure.
Electrocardiography	During the study in the form of a curve on paper, currents are recorded that occur in the heart muscle. The doctor assesses the heart rhythm, the condition of the muscles, ventricles and atrial.	Electrical heart pulses are recorded using a special device - electrocardiograph, - through electrodes attached to the wrists, ankles, chest.

Is it possible to carry out Plasmapheres in pregnant women?

Pregnancy is not a contraindication for plasmapheresis. This procedure is carried out in pregnant women in the following testimony:

in preventive purposes during pregnancy preparation, especially in women who smoke and have professional harm;
prevention and treatment of infections during pregnancy;
autoimmune states, for example, reserves-conflict of mother and fetus;
fetoplacentar insufficiency.

Is plasmapheresis effective with allergies?

Allergies are a pathological condition at which the body's immune system reacts too violently to external stimuli. The lymphocytes are highlighted in blood a large number of antibodies that begin to connect with antigens trying to destroy them. During the plasmapheres procedure, antibody and immune complexes can be removed from the blood. Therefore, this technique is widely used to treat allergic and autoimmune diseases.

Usually enough from 3 to 5 procedures. After that, the effect remains for 3 to 6 months.

Is it possible to use plasmapheresis in healthy people for the prevention and overall cleaning of the body?

Plasmapheresis can be used in a healthy person for the prevention of autoimmune, infectious and other diseases, in professional hazards, to promote health and increase the total tone of the body.

But it is worth remembering that in medicine Plasmapheresis is considered surgery. That is, according to the degree of invasiveness (penetration into the body), it is the same as the operation. Possible certain complications. Therefore, before signing up the course of procedures, be sure to consult your attending physician.

Plasmapheresis of blood is used to get rid of it from toxins or reduce the number of other components, for example, erythrocytes, platelets, leukocytes. Mechanical filtering can be both therapeutic and donor. In the first case, after cleaning, the blood returns back to the patient, in the second - freezed for temporary storage.

For therapeutic purposes, the Plasmapheresis resorted if necessary to quickly eliminate intoxication, inflammatory processes, the normalization of metabolism, when it is necessary to maintain a certain composition of the blood or to create such an operational intervention.

What is this procedure

Answering the question that it is plasmapheresis, it should be noted its significant difference from hemosorption, which is also used to clean the blood. In plasmapheresis, its fence and separation of fractions occurs, with the second procedure, treatment is carried out by sorbents.

Break therapeutic and donor plasmapheres. The first is used to normalize the patient's condition at various acute and chronic states.

Blood blood is divided into uniform elements (leukocytes, platelets, erythrocytes) and a plasma consisting of saline solutions, protein and other compounds.

After cleaning the patient, the missing fluid is poured back, replacing a damaged "dirty" part. The donor procedure involves the fence and plasma storage for subsequent introduction to people in need.

In general, the task is to normalize the volume of components of circulating blood, the removal of toxins, paracoagulation products, mediators of inflammatory processes, transportation in the body of the missing elements of coagulation, immunoglobulins.

Effect

When the course passes (from 2 to 6 sessions), the patient feels a significant improvement in his condition. This is explained by the fact that when normalizing the composition of blood, the organs begin to function better, feeding only the useful environment.

In addition, when cleaning the body, a response occurs and protective reactions are mobilized, in other words, immunity increases.

How is the procedure

In the course of treatment, it is recommended to pass at least 3 sessions. On the first, only substances circulate in the free state of the bloodstream are eliminated. In the second, the products from the intercellular fluid become available. And on the third session all the pathogenic substances of the cells are eliminated.

At one time you can remove the fourth part of the entire volume of the plasma, from the total amount of blood it will be the eighth part. The exact amount is determined by the weight and age of the patient.

Stages of holding

Plasmapheresis can be carried out both after 1 and through 2 catheters.

An essential difference is that in the first case, a small dose is first happened, then cleaning, and then the refund of the processed substance. With the second version, the process is continuous, through one catheter the blood is gained, and through the second in the other hand immediately introduced back.

The fence implies pumping a certain amount of blood along with all toxins, viruses, bacteria, cholesterol and uniform elements. At the same time, the patient is in consciousness, in a lying or a semi-dying position. The catheter is installed in the elbow vein.
Blood is divided into fractions, passing through the device.
The plasma is completely pumped out, and the remaining suspension is saturated with saline, glucose, potassium chloride, albumin, refooliglucin.
The resulting mixture is supplied back into the patient's body.

Types and classification

According to the method of execution, hardware and discrete type are isolated. For its intended purpose there is a therapeutic and donor view.

By processing method Plasmapheresis may be:

Centrifuge, or gravitational. The hemophhenix apparatus at high drum rotation speed shares blood on the fraction. Since this method is very damaging the cells, it is very rare to it.
Membrane, or plasma filtration. It practically does not have contraindications and takes a minimum of time, cells in the process of cleaning are not damaged. Application apparatus with filter-pores.
Sedimentation, or setting method. Refers to the cheapest and rarely applied. The blood in this case is not subjected to hardware processing, but only a certain amount of time is defended. This method does not allow to purify large volumes, therefore the spectrum of use is small.
Cascade Plasmapheresis. It is shown in severe states of autoimmune patients, as well as applied in surgery and resuscitation. The main difference is the double cleaning method. First, the cellular part is filtered, then the plasma. The disadvantage is the high cost of manipulation.
Cryophersopheres. The collected blood is subjected to freezing at low temperatures, and then heating and centrifugation. The axial part does not apply. Scope - elimination of the effects of strong poisoning and, as a result, intoxication.

Indications

Plasmapheresis is used to eliminate substances from the body provoking the pathological process.

Treatment is prescribed at:

The need for urgent disposal of plasma from toxins and metabolic elements caused by autoimmune ailments or inflammatory processes. For example, with rheumatoid arthritis, asthma, sclerosis, hypertension, neuropathy.
The needs of maintaining a long time of a certain composition of blood. At the same time, only one zone of pathogenesis is excluded. Usually, the testimony for use is a rhesus conflict, diabetes, viral hepatitis, in the process of treating oncological pathologies, poisoning of poisons, toxins of bacterial origin.
Preparation for the operation, if the primary composition is unacceptable for surgical intervention.

In general, the mechanical purification of blood can be used in complex therapy at:

Multiple myel.
Extensive destruction of red taurus in vessels.
The presence of free mioglobin in the blood.
Hemoglobinopathy.
Miasthenia.
Diseases of Hasser, Crown.
Porphyry.
Intoxication by chemical poisons.
Rheumatism.
Viral myocarditis.
Asthma, chronic pneumonia.
Ulcerative colitis.
Endocrine pathologies, in particular diabetes.
Peritonitis, sepsis.
Significant burns.
Rejection of the organs after the transplantation.
Herpes, Psoriasis.
Glomerulonephritis.
Allergic encephalitis.
Vascue.

Contraindications

In some cases, even a useful procedure can lead to a worsening of the patient's well-being, so it is not recommended to be carried out at:

Anemia when hemoglobin is less than 80 g / l. If you resort to manipulation in this case, oxygen starvation will increase.
Bleeding of any character.
States when the body is not enough blood. Usually in this list are the pathology of the cardiovascular system, as well as an ulcer and post-infarction gap.
Reducing the amount of protein in the blood (less than 60 g / l). This indicator is responsible for the permeability of the vessel walls and the level of the liquid component of the blood inside them. The procedure for deviations from the value from the norm disrupts the water and electrolyte balance and increases the pressure.
Machion of brain vessels due to circulatory disorders.
High blood pressure.
Liver dysfunction.
Heart diseases.

All contraindications can be:

Absolute when there are significant damage to the brain, heart, liver, lungs, kidneys or severe bleeding.
Relative. This includes blood diseases when the risk of extensive bleeding, and states provoking bleeding are increased. For example, an ulcer, hypotension, pregnancy, monthly, infectious diseases.

It is also better to abandon the manipulation of allergies or if negative reactions to blood transfusion were previously observed.

Benefit and harm from the procedure

Plasmapheresis is rarely carried out as a single treatment for the patient, it is usually a subsidiary event than and the successfulness is explained.

The advantages of choosing a method include:

Detoxification. Elemental toxins occurs by "laundering" of blood cells. In fact, a differentiated assessment helps disconnect fractions with harmful substances, and useful to return back to the bloodstream.
Stimulating the hematopoietic and cardiovascular systems on the reflex plan. In this case, the body is located in the recommended water and electrolyte balance. When there is a need, instead of plasma in the bloodstream, solutions can be introduced that replace it.
Immunomodulation. Blood contact with plasma filter structures irritates immunity cells, which helps to improve their performance. But with autoimmune diseases, this may have the opposite effect, as the effect of tissues against its own body will increase and this will cause an aggravation of the ailment. Therefore, under therapy of such pathologies, constant medical control is needed.

Harm from the procedure can be completely absent, be minimal or, with some features of the body, lead to patient's death. To minimize side effects, the doctor must fully examine the patient before plasmapheresome and prescribe treatment only with serious indications.

In most cases, everything is limited to the headache, nausea and pressure jump, which is explained by the body's reaction to extreme conditions and does not carry a serious threat. At the same time, an allergic reaction may develop, including an autoimmune from the renal apparatus to the donor plasma.

In addition, blood cleaning implies the removal of both harmful and useful components, which can temporarily weaken the immunity. If the personnel is incorrect and incompetent, the risk of infection, the formation of thromboms, the development of sepsis, metabolic disorders.

Possible complications

Even with a favorable picture of the survey before the procedure in the process of execution, the body can negatively respond to the manipulations carried out.

Most often, patients identify the following complications:

Hypotension. A sharp decrease in blood pressure may cause oxygen starvation. In serious case, it ends with disabilities or fatal outcome.
Anaphylactic shock. Allergic manifestations include changes in hemodynamics, chills, vegetative disorders. When untimely assistance can lead to death.
Internal extensive bleeding. That is why, with ulcers or erosive areas on the mucous gastrointestinal tract, it is better to abandon the procedure.
Citrate intoxication in which the patient can go to whom, that ends with death. Fortunately, this is a single case.

If poor health is observed, it is necessary to interrupt the procedure. If this happened beyond the walls of a medical institution, immediately consult a doctor or call an ambulance.

Preparation for the procedure

To reduce the risk of complications from manipulation, special preparation is recommended before it is fulfilled.

For this you need:

Normalize proper nutrition, stick with a high protein diet, but reduce phosphorus consumption, potassium, sodium.
Sewing and use a large amount of liquid on the eve of plasmapheresis.
Refuse smoking.
To pass a medical examination.

The therapist examines the patient, measuring the blood pressure, prescribes a clinical and biochemical blood test, determining the glucose indicator, the reaction of Wasserman, RW, coagulogram, ECG.

Conducting during pregnancy

The procedure is useful in preparation for the conception of the baby, especially for women who smoked a lot before that. This method helps to withdraw a cigarette poison.

During the tooling plasmapheresis can be shown at strong toxicosis. Improvements will be after a couple of sessions.

In addition, during pregnancy, the risk of intrauterine infection, oxygen starvation of the fetus, lowland and extensive bleeding during childbirth is reduced.

How long does one session and the course last

On average, one session lasts 1.5 hours. Repeat plasmapheresis can be 3-4 days later.

In therapeutic purposes, time increases, the duration of the procedure reaches 2-3 hours, and the frequency is 4-5 times a week. The course includes 3-6 sessions. The number of procedures is selected individually depending on the sharpness of the flow and the characteristics of the illness. You can repeat the treatment after six months.

Apparatus for Plasmapresa

The devices can be portable or stationary. The first is convenient because they can be installed anywhere, not anxious to the patient, if necessary, even at home. There are devices that first take a minor portion of blood clean it and return it back.

Such instruments per minute patch 100-150 ml of biological fluid. Others contain 2 catheters in order to take one after one, and through the other immediately return back. In this case, the device does not stop the process.

The plasma filter contains centrifuges, membranes, pumps or filters. It all depends on the choice of the method.

Cost

The price for one session is very different and can be from 2000 to 60000 rubles. The cost depends on the selected method of treatment, the knowledge of the clinic, the experience and competence of the doctor. The region has considerable significance: the closer to the center of the capital, the more expensive.

Due to the presence of various methods, each patient may choose the desired way, focusing on its price. We should not forget that one procedure is usually not enough, they are carried out at least three.

Application of the method for disease prevention

Despite the fact that the benefits of this manipulation is significant, plasmapheresis refers to serious interventions in the structure of the body.

When it is fulfilled, a significant part of blood is closed, its structure and formula changes, certain elements are retrieved or dying. To fill it take a long time.

In addition, all organs feel the lack of an intercellular fluid during the restoration of the plasma volume. According to the majority of specialists, such a load on the volatile system and the body as a whole for the purpose of prevention is not justified.

The methods of efferent therapy help to restore violations in the work of homeostasis. Plasmapheresis is also a variety of this group. Its advantage is that you can quickly extract toxins and normalize the desired blood composition.

Despite all the advantages, it is not worth resorting to the procedure for prevention, as it is a considerable stress for the body. To avoid complications, the patient's manipulation is carefully examined, and in the process, they are observed for indicators of pressure and work of vital systems.

In the modern world, the human body is increasingly forced to contact with exhaust gases, tobacco smoke, alcohol-containing drinks, medicines, eradicates, etc. accumulating, harmful substances provoke the appearance of various pathologies. To date, one of the most effective ways to purify the body from poisonous products is the treatment of plasmapherester. With this method, a plasma containing all harmful substances is removed from the patient's blood.

Plasmapheresis - blood cleaning, as a result of which, outside the body of a person, the biological material is divided into "good" and "bad". The first is returned back to the body, the second is utilized.

Initially, this reception was used to handle donor blood. But today the plasmapheresis procedure is recognized as one of the most effective methods of organism rehabilitation. In addition, the method is purposefully applied to combat some diseases.

Views

Plasmapheresis of blood is a medical procedure implying the fence of the patient's venous blood and its subsequent separation into the components. After that, the purified biomaterial is introduced back. As for the plasma donation, only uniform elements are returned to the venous direction.

The procedure can be carried out both using special equipment and without it.

There are the following advancement methods:

Gravitational. Its principle is based on the action of gravity. The uniform elements of blood having a greater weight are lowered at the bottom of the tank, they are introduced back to man. Due to the low performance indicator in practice, this method is extremely rare.
Filtration. The essence of the method is the same as the gravitational. The difference is that there are special filters in the process, thanks to which the separation into the components occurs over a smaller period of time and better.

To date, the above techniques lose relevance, yielding those that are carried out using equipment.

In practice, multiple apparatuses for plasmapheresis differ in functionality are used. Nevertheless, it is possible to divide blood into components in two ways.

Based on this, the hardware plasmapheresis is 2 species:

Centrifuge. The method allowing you to get a "good" fraction for the shortest possible time. Due to this, the integrity of cellular structures is not disturbed and the properties of other components are saved. The essence of the procedure: Blood in a special container is placed in a centrifuge equipped with modern software, and is separated at high speed a few minutes. The tank is then removed and plasma contaminated with harmful substances is removed from it.
Membrane. The essence of the method: the patient's blood is distilled through special filters using pumps built into equipment. This method is also characterized by high speed. In addition, the procedure of membrane plasmapheresis allows you to treat a large blood volume along with the maximum possible degree of cleaning. In most cases, the method is used to treat various pathologies. With the help of membrane plasmapheresis, improvements can be achieved in a patient state even with severe diseases. In some cases, the effectiveness procedure is superior to medication therapy.

Indications

Plasmapheresis is not a preventive measure to which everyone can resort. The procedure is carried out only on the recommendation of the doctor. As a rule, it serves as an additional treatment method in the case when the main therapy scheme does not bring positive results.

Indications to Plasmapheresis are the pathologies of most organs and systems:

damage to the heart muscle;
high level of "bad" cholesterol in the blood;
complications after the suffered infarction;
rheumatism;
atherosclerosis;
myocarditis of viral origin;
diseases of vessels of lungs;
bronchial asthma;
alveolit;
pneumonia;
crohn's disease;
damage to the wall of the large intestine, accompanied by the appearance of an ulcer;
liver pathology;
inflammation of the mucous membrane of the oral cavity;
diabetes mellitus, including his violations;
problems of dermatological nature (allergic rash, psoriasis, urticaria, etc.);
arthritis;
pathology of the visual system;
failures in the work of the kidneys;
seasonal diseases (high sensitivity to cold, warmth, etc.);
multiple sclerosis;
oncological diseases;
thromboembolia;
hepatitis;
pathology of the reproductive system;
resh conflict during the fetus period;
acne;
alcoholism;
use of narcotic substances;
poisoning poisoning and drugs.

This list can be expanded during individual consultation with a specialist. To date, the procedure is successfully used in the struggle of about two hundreds of diseases. Judging by the medical reviews, plasmapheres in combination with drug treatment makes it possible to achieve significant improvements.

Contraindications

The procedure has a number of restrictions. The decision on the need for its purpose takes the attending physician after a thorough examination.

Absolute contraindications to Plasmapheresis are:

lesions of the brain of extreme severity;
bleeding.

There are also restrictions that, by decision of the doctor, can be neglected. Relative contraindications to Plasmapheresis are:

Next to bleeding. The procedure implies the use of drugs that reduce the resultability. This is important in order for the installed catheter not clogged with blood closures. In this regard, the risk of bleeding is increasing.
Ulcerative lesions of the gastrointestinal tract. After plasma examination, the risk of bleeding is also increased.
Arrhythmia, reduced blood pressure. Despite the fact that the patient is deprived of a certain amount of blood not short time, the work of the cardiovascular system may worsen. Against the background of the procedure, blood pressure decreases and arrhythmia is enhanced, which can provoke the appearance of dangerous states.
Lack of protein in the blood. These substances are vital to ensure the normal operation of all organs and systems of the human body. After the procedure of blood purification, some of their quantity is lost, which increases the risk of various pathologies.
Infectious diseases in the acute stage. This limitation is explained by the fact that the cardiovascular system during this period is experiencing an increased load.
Menstruation. The procedure during menstruation can significantly worsen the overall state of the woman.

Positive action

Reviews of Plasmapheresse most people are exceptionally positive. Patients celebrate improvement in well-being, tide of strength, increase in working capacity.

The benefits of Plasmapheresis:

the protective forces of the body are strengthened;
the level of "bad" cholesterol in the blood is reduced;
metabolic processes are accelerated;
cells are better saturated with oxygen.

The benefits and harm of plasmapheresis are due to the adequacy of the appointment of the procedure, as well as the correctness of its implementation. Compliance with all conditions reduces the likelihood of side effects.

Immediately after plasmapheresis, the following states may occur:

weakness;
dizziness;
turbidity of vision.

These reactions are normal and do not require medical care. To eliminate them, it is recommended to lie down for 15-20 minutes.

After plasmapheresis, the following complications are possible:

Allergic reaction. It can be caused by drugs that are used to dilute blood. It is manifested by chills, rashes, fever, less often an anaphylactic shock develops. In the case of poisoning, it is observed: numbness of various parts of the body, convulsions.
Bleeding. There may be a consequence of overdose substances that reduce the rate of consumption. The risk also increases with the existing peptic diseases of the gastrointestinal tract.
Thrombosis. If the dosage of the aforementioned substances, on the contrary, will be insufficient, the catheter and the wall of the vessel in which it is installed, can be broken with blood clots. If the thrombus falls in the direction, the likelihood of severe states will increase.
Sepsis, infection of HIV. Currently, during the procedure, only sterile disposable needles and tools are used, which reduces the risk of infection to zero. It is important to apply only to medical facilities that have a license to carry out transfusion.

Preparation for Plasmapheresu

Before the procedure, the patient must undergo a survey. It includes:

General blood analysis. It is important for identifying various pathologies at an early stage.
Coagulogram, estimation of speed of consumption. Allow to detect predisposition to bleeding or, on the contrary, thrombosis.
Vasserman reaction. Analysis that detects syphilis.
Research on the determination of blood glucose levels. It is necessary to exclude or confirm the presence of diabetes.
Analysis on the content of proteins in the blood. The reduced level of these substances is a relative contraindication to plasmapheresis.
Fractional pressure measurement. At large deviations from the norm in any direction, the procedure can be postponed.
ECG. It is necessary to evaluate the work of the cardiovascular system.

48 hours before plasmapheresis need:

To eliminate the use of alcohol-containing drinks and coffee.
Drink at least 2 l bottled non-carbonated water per day.
Stop receiving medicines that can provoke the appearance of complications. The doctor should be discouraged in advance, he determines which of them you need to stop drinking.

Immediately before the procedure, you need to empty the bladder, for 2 hours it is forbidden to smoke.

How to run

The algorithm for the implementation of plasmapheresis includes the following actions:

The patient is placed on a special chair. For convenience, it can take both a sedentary and a supreme position.
A catheter is installed in Vienna, through which blood begins to flow into the sterile package. As a rule, the optimal option is the vessels located in the area of \u200b\u200bthe elbow bend. If they are not viewed in this zone, the catheter is installed in a subclavian vein. The fence of the biomaterial is carried out 1-3 times. This is due to the fact that over one session is cleared about a third of blood. Subsequent times from harmful substances are exempt cells. Due to this, purification is considered better and more efficient. For one procedure, 350-500 ml of blood is enough.
The filled package is placed in the equipment where the separation of liquid connective tissue on plasma and uniform elements occurs. Cellular mass diluted with blood substitutes is returned to the venous bed through an already installed catheter. If a centrifuge method of plasmapheresis is used, the separation can occur automatically without the need for additional manipulations. In this case, the patient is simultaneously installed 2 catheters. From one tube, the biomaterial in small portions enters a centrifuge apparatus, where separation is subjected. The plasma is immediately drained, and the shaped elements are mixed with blooding preparations and are introduced back into the venous part of the patient by means of a second catheter. In view of the need to acquire expensive equipment, centrifuge automatic plasmapheresis in practice is used quite rarely.
Upon completion of the procedure, the patient is still some time (about 30 minutes) is recommended to be under the supervision of a doctor.

The duration of the session is an average of 1-1.5 hours. In the reviews about Plasmapheresse, in addition to its effectiveness, it focuses on the fact that during the procedure there is no slightest discomfort.

Cost

The price of Plasmapheresis is formed in each medical institution in different ways. Nevertheless, the procedure is considered very expensive.

For example, in Moscow, Plasmapheresis is carried out in most multidisciplinary clinics. The advantage of private organizations is the presence of a flexible discount system for regular customers. The cost of Plasmapheresis in Moscow is an average of 5-8 thousand rubles. In other cities, the lower threshold is less. For example, the average price of Plasmapheresk in Khabarovsk - 3-7 thousand rubles.

Plasmapheres - This is a procedure that is intended for blood purification. There are many diseases that require the use of such a method, and more and more often in medical practice there are cases when he really helped get rid of the disease.

But Plasmapheresis, being a rather complicated procedure, has not only indications, but also contraindications. Before you know about them, consider the views of Plasmapresses.

Types of Plasmalisa

Initially, Plasmapheresis is divided into therapeutic and donor. The difference between them is that with therapeutic method, the blood of a person after processing is returned, and thus someone else's blood is not used. In the Donor Plasmapheresis, the blood of another person participates.

On the organization and methods of blood processing plasmapheresis are also divided into groups:

Centrifuge (additional names - gravitational, discrete, intermittent) - In this case, centrifuges are involved in the methodology.
Filtration - blood is cleaned with special filters.
Membrane Plasmapheresis - Membranes are used that share plasma collection chambers and blood chambers; One of the most popular methods today.
Cascading plasmapheresis - used since 1980, and its feature is blood filtering using a microporous filter, which delays large-molecular weight proteins and misses low molecular weight.

Indications for blood purification using plasmapheresis

First of all, Plasmapheresis is used to clean blood from toxins, and pushing out this, it is not difficult to guess, under what diseases it is relevant.

Especially interesting cases of practicing the treatment of plasmapheresome atypical allergic reactions that may have an autoimmune nature. In many cases, it is appointed when allergies cannot eliminate classical methods - diets and medicines. But, unfortunately, it is not always an effective way to treat autoimmune diseases.

It is believed that with autoimmune processes plasmapheresis gives a visible effect at first, but then the disease is activated with a new force.

It can be assumed that in the dermatological region plasmapheresis used most often. From common considerations, plasmapheresis is prescribed with psoriasis, furunculosis and eczema. Of these 4 pathologies, most often persistent positive effect is observed in patients with furunculosis.

In Gastroenterology, plasmapheresis is used for diseases that lead to the pollution of the body toxins -, pancreatitis, hepatitis. Some believe that Plasmapheres renews the entire organism, and especially the immune system.

In endocrinology, plasmapheresis is used for diseases of the threshold, in particular, with thyrotoxicosis in the remission stage, as well as with diabetes mellitus.

Another autoimmune disease, which is treated with this method - multiple sclerosis. Plasmapheresis with multiple sclerosis will not necessarily lead to relief, but the likelihood is great that it will brake the progression of the disease.

To activate the spare forces in the body, sometimes resort to Plasmapheresa, however, before such serious intervention in the body is worth trying traditional treatment methods.

Also plasmapheresis helps to eliminate multiple chronic infectious diseases.

The procedure for cleansing the blood - Plasmapheresis, became very popular, the word "cleansing" brings incomes of fraudsters in white coats, acting like hypnosis, rather "cleaning" the wallets of our citizens, because the procedure is very expensive, while the assurances of doctors need to pass at least 5 procedures . Thus, honey - centers are enriched.

Plasmapheresis - Extracorporeal Blood Purification . It is divided into a centrifuge, hardware and membrane.

Membrane. Blood plasma filtration, with a special membrane, on which too large protein molecules are settled: immune complexes, lipoproteins, antibodies.

Centrifuge 450 - 500 grams of blood are carried out and separated in a plasma centrifuge and cellular mass. In the cell substance, a saline or other blood substitute is added and poured the patient again. And the plasma is destroyed.

In general, the essence of the procedure is that the patient take blood and separated it on plasma and red blood cell mass. It is plasma that contains pathogenic proteins, microbes, dead cells and others. The plasma is thrown out (if it is not a membrane cleaning method), and instead of it, blood mixed with medicines or donor blood is poured. Read more about Plasmapheresis methods. Find out from Wikipedia.

Plasmaphersis harm

There are pathologies at which there is no plasmapheresis. Sometimes in this situation, this is the only hope, for example, it is necessary to get rid of the pathological protein during myeloma disease or in monoclonal gammapaty (this is a whole series of diseases in which abnormal immunoglobulins are synthesized in the body), surge cell anemia or with Julian's syndrome -Barre. Although there is another list of diseases under which the procedure is recommended, but it is the prerogative of narrowly directed specialists, not every doctor will figure it out.
A person intends to clear the blood, refers to the objective (as it seems) to the Internet. The search engine will issue hundreds of links when queries: "blood purification" or "plasmapheresis" and advertising of medical centers offering a dangerous procedure to everyone, describing plasmapheresis as a safe and 100% effective effective from all common diseases: dermatitis and any other skin diseases, diabetes , and others. Moreover, it is indicated that the procedure can be carried out without prior analyzes and health examinations.
Doctors silent about the fact that the method has a lot of contraindications and it is deadly. Always any medicine has its recommendations and contraindications. From the list of diseases in which plasmapapheresis use, it becomes clear that the procedure is not simple, but the fact that individual "specialists" offer to get rid of chronic fatigue, pain in the joints or will be cleaned of toxins, is extremely dangerous for the patient's life and not ethic "Doctor".
To understand this, let's turn to the statistics: And she says that 0.05% of patients who have passed the procedure for cleansing blood, die from it.
Mortality among those with thrombocytopenic purple pathology is more than 30%, and some of them will die from the blood purification procedure. But, with such a high mortality, this is meger, because Plasmapheresis, the only thing that will help keep life.
But, take 10 thousand healthy people, 5 of them will die from the procedure. It is criminally a lot, for you need to judge.
Experts (charlatans ready for all of money for all), who know the testimony to purify the blood and statistics of mortality, still advertise it to everyone, thereby consciously exposing a man of death hazard.

Side effects of Plasmarteze

From a harmless allergic reaction to anaphylactic shock, there may be electrolyte pathologies: a decline in the level of calcium and potassium, a decrease in blood pressure, infection.
Sharp drop of blood pressure
Pulmonary edema
Pneumonia
According to official statistics 1 Female outcome by 5000 procedures
Plasmapheresis is used to treat hazardous diseases or to facilitate heavy pathologies in which there are already little, which helps.
Plasmapheresis is a dangerous procedure provoking heavy complications, and even a fatal outcome. Risk is minimal, only with deadly diseases.
If a medical worker advises this method, everyone who wants to withdraw and improve health. Then this violation of medical ethics and the main rule "not harm" and a person needs to be deprived of a doctor's diploma.

Purification of blood is one of the methods of enrichment of medical centers ,. Plasmapheresis, used only for severely ill, and strict indications.