Friday, June 15, 2012

AFERESIS


DEFINITIONS
Aferesis is the separation of blood components directly to the person using the blood component separator

PURPOSE
Removing some blood components, can be either cell (cytopheresis) or plasma (plasmapheresis / plasma exchange)

INDICATIONS

therapeutic:
Sitoferesis
Eritrositoperesis: Sickle cell anemia, malaria parasitaemia
Tromboferesis: Trombositemia symptomatic
Leukoferesis: Leukemia with hiperleukositosis, rheumatoid arthritis (in certain circumstances)
Plasmapheresis: Abnormalities of paraprotein (hyperviscosity syndrome, cryoglobulinemia, Fabry disease, familial hypercholesterolemia), immunological abnormalities (Goodpasture's syndrome, myasthenia gravis, eaton-lambert syndrome, guailain-barre syndrome, pemphigus, ITP, an inhibitor of coagulation factor), vasculitis (SLE, glomerulonefriitis mesangiokapiler, Wagener's granulomatosis), deficiency of plasma factor (TTP), toxicity of drugs or other toxic materials.

donor:
To meet the needs of the patient's blood components:
Tromboferesis
Plasmapheresis
Leukoferesis, to support the program PBSCT

CONTRAINDICATIONS
Aferesis therapeutic
Patients with poor conditions and hemodynamic disturbances
Aferesis donor
Levels of platelet / leukocyte / albumin / hemoglobin / hematocrit below the normal
ABO-Rh type is not suitable, cross matching the (+)
Contain HBsAg / anti-HCV / HIV / VDRL and malaria
less weight, old age, children
Suffering from heart disease, lung, kidney failure, chronic or acute diseases other
PREPARATION

Materials and tools:
Machine aferesis
Set aferesis disposable, set trombaferesis, plasmapheresis sets, set leukaferesis, set eritositaferesis
anticoagulant ACD-A
Intravenous Access
AV fisual
Heparin injection of 0.9% saline infusion
Albumin (to plasmapheresis)
Emergency Drugs: Ca gluconate injection, inj adrenaline, corticosteroid inj, inj antihistamines, saline infusion, plasma expander, oxygen, resuscitation equipment and emergency drugs for resuscitation

patients:
Explanation of procedures that will be undertaken
Physical examination: hemodynamics, weight, height
Laboratory: ABO-Rh blood goals, cross-matching, DPL, HBsAg, anti HCV
Informed consent
Swallowing calcium tablets a day earlier

COMPLICATIONS
Hypocalcaemia (tingling lips and fingers, chest distress, dark view) hemodynamic disturbances and impairment of consciousness

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