Hemodynamics in donor plasmapheresis

Several studies have demonstrated that preoperative withdrawal and storage of autologous plasma as fresh frozen plasma is effective in blood conservation. For that purpose patients with elective surgery (orthopaedic surgery, open heart surgery, neurosurgery and others) have to undergo donor plasmapheresis without staying in the hospital. Depending upon the need the procedure can be performed several times preoperatively, taking about 900 ml in a normal weighting subject at once. The collection of autologous plasma should be finished at least 14 days before surgery. In order to investigate the haemodynamic effects of donor plasmapheresis 30 patients scheduled for coronary bypass surgery were devided into two groups. 15 patients underwent plasmapheresis (10 ml plasma/kgbw) by one-needle-technique using a Haemonetics seperator (PCS) after premedication but before onset of anaesthesia. Blood withdrawal was performed with 0.5 ml/kgbw x min. Another 15 patients, serving as control had no plasma withdrawal and were measured at identical times as the other group. Both groups had an identical fluid replacement with 500 ml Ringer's solution during the investigation period. Plasma withdrawn was not substituted by colloidal solution (simulating the situation when plasmapheresis is performed at the outpatient). Haemodynamic measurements (both groups) included heart rate, arterial blood pressure, right- and left-atrial pressure, systemic- and pulmonary-vascular resistance and cardiac output. There were no relevant effects of plasmapheresis on haemodynamic function during and after the investigation period in that patients: neither heart rate, blood pressure or vascular resistance changed significantly nor did pre- and afterload or cardiac index. No differences to the group without plasmapheresis could be observed.(ABSTRACT TRUNCATED AT 250 WORDS)