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치료적 혈장교환술에 사용하는 치환용액의 선택과 주의사항

Other Titles
 A Choice and Precautions of Replacement Fluids for Therapeutic Plasma Exchange 
 최계령  ;  최승준  ;  신새암  ;  이경애  ;  김신영  ;  김현옥 
 Korean Journal of Blood Transfusion, Vol.26(1) : 9-17, 2015 
Journal Title
 Korean Journal of Blood Transfusion  (대한수혈학회지) 
Issue Date
Background: Therapeutic plasma exchange (TPE) is an effective and practical treatment for separation and removal of harmful antibodies or pathogenic substances from the blood. The volume of plasma removed must be replaced by a replacement fluid such as 4∼5% albumin solution or Fresh frozen plasma (FFP). We conducted a study of coagulopathy using albumin solution and checked the chemical composition of fresh frozen plasma. Methods: We measured pre- and post-TPE PT/aPTT for evaluation of the effect of albumin replacement on coagulation from 192 TPE sessions of 19 patients. We also investigated routine chemistry test items including glucose and electrolytes from 10 randomly selected FFP. Results: The post PT and aPTT within four hours after TPE were prolonged due to a transient decrease in coagulation factors, but were normalized within 2 days after TPE. All coagulation time was corrected to the level of the pre-TPE status within four hours before the next TPE except the patients who received TPE 6 times or more. FFP showed higher level in glucose, sodium and inorganic phosphate. Conclusion: Albumin exchange produces temporary coagulation factor deficiency. However, this transient factor deficiency rarely causes clinical problems and the factors are rapidly corrected by redistribution and resynthesis. We should be careful about hypocalcemia, hyperglycemia, and hypernatremia when using FFP replacement.
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1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
김신영(Kim, Sin Young) ORCID logo https://orcid.org/0000-0002-2609-8945
김현옥(Kim, Hyun Ok) ORCID logo https://orcid.org/0000-0002-4964-1963
신새암(Shin, Saeam) ORCID logo https://orcid.org/0000-0003-1501-3923
최계령(Choi, Gye Ryung)
최승준(Choi, Seung Jun) ORCID logo https://orcid.org/0000-0003-0736-1055
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