A detailed discussion on a very much in demand topic. Covered all aspects of the procedure which are important for an Emergency, Medical and Intensive Care physician should know. Nurses can also benefit from the presentation as we have tried to keep it as simple and straight forward as possible.
A detailed discussion on a very much in demand topic. Covered all aspects of the procedure which are important for an Emergency, Medical and Intensive Care physician should know. Nurses can also benefit from the presentation as we have tried to keep it as simple and straight forward as possible.
Understanding of hemophilia increased over years, better understanding now lead us to better comprehensive care for such unfortunate patients. this presentation is derived from the text of world federation of hemophilia and indian academy of pediatrics.
Understanding of hemophilia increased over years, better understanding now lead us to better comprehensive care for such unfortunate patients. this presentation is derived from the text of world federation of hemophilia and indian academy of pediatrics.
Surgery resident postgraduate presentation on the use of blood and products presented dept of surgery, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
3. Define & identify the indication of plasmaphoresis in
renal disease
Outline appropriate therapy
Detailed instruction for the equipment involved in
plasmaphoresis
Highlight potential complication of plasmaphresis
4. It is the removal of large volumes of plasma to be
replaced by fresh frozen plasma or albumin solutions.
It is an extracorporeal therapy and as such is
dependent on adequate vascular access.
The terms "plasma exchange" and
"plasmapheresis" are often used inter-changeably
Definition
5. Plasmapheresis Functions
Removes Immune Complexes
Removes Antibodies
Removes Plasma (for high lipids)
Removes/activates Complement
Removes inflammatory mediators
Infuses FFP or IVIG (blocking antibodies which
attach to Fc portion of antibody)
Can be thought of as another immunosuppressant.
6. Common Indication Of
Plasmaphoresis In Nephrology
Good pasture's syndrome
Hyperviscosity syndromes
Cryoglobulinemia
Paraproteinemia
Waldenström macroglobulinemia
Thrombotic thrombocytopenic purpura(TTP)/ HUS
Wegener's granulomatosis
Microscopic polyangiitis
Antiphospholipid Antibody Syndrome(APS or APLS)
SLE (Lupus cerebritis).
Recurrent FSGS & ABS mediated in kidney Tx.
8. Like that of CRRT
◦ Central lines may be percutaneus or tunnelled (permicath).
◦ The tunnelled one is preferred as plasmaphoresis result in
profound immunosuppression.
9.
10.
11. 1. Centrifugal cell separators
Centrifugation takes advantage of the different
specific gravities inherent to various blood products,
such as red blood cells (RBCs), white blood cells
(WBCs), platelets, and plasma
2. Membrane Plasmafiltration:
Uses highly permeable membranes
Plasma passes through the membrane pores, whilst
the cells are simultaneously returned to the patient
Techniques of Plasmapheresis
16. Techniques of Plasmapheresis
Membrane apheresis Centrifugal devices
Advantage:
• Fast and efficient plasmapheresis
• No citrate requirement
• Adapted for cascade filtration
Disadvantage:
• Removal of substance limited by
sieving coefficient of membrane
• Unable to perform cytapheresis
• Requires high blood flows, central
venous access
• Requires heparin anticoagulation
limiting use in bleeding disorders
Advantage:
• Capable of performing
cytapheresis
• No heparin requirement
• More efficient removal of all
plasma components
Disadvantage:
• Expensive
• Requires citrate anticoagulation
• Loss of platelets
17. Gambro PF 1000 N/ 2000 N
Blood flow
◦ Optimum 100-150 ml/m
Prime:
◦ Pf 1000N need 2000ml of N.saline with the last 1000 cc
contain 5000 iu heparin.
◦ Pf 2000 N need 3000ml of N.saline with the last 1000 cc
contain 5000 iu heparin.
Min. Bl. flow
Max. Bl.flow
Max. TMP
Priming vol.
Surface area
50ml/m
200ml/m
200
23 ml
0.15 m2
PF 1000 N
100ml/m
250ml/m
120
41ml
0.35 m2
PF 2000 N
19. Volume:
◦ 1- 1.5 plasma volume/ session that can be calculated by:
◦ Plasma volum in L= (0.0625 XWt (kg) )X (1- haematocrit)
◦ Plasma volume= 40 X Wt/kg
Rate:
◦ It is determined by blood flow (100-150 ml/m) that equal to
Uf rate of 30-35/m & 45-55 ml/m respectively).
◦ The plasma filtration rate vary indirectly with haematocrit
Duration:
◦ Duration /m= (plasma volume X exchange volume) / plasma
filtration rate
20. Check clotting /CBC before and after therapy
Continuous ECG & Bl. pressure monitoring to detect
hypotension & dysrrythmias.
Monitor body temperature and maintain it > 36
22. Fresh frozen plasma:
◦ Indicated in hemolytic uremic syndrome &
thrombotic thrombocytopenic purpura.
Initially Albumin 5% followed by
FFP/Albumin 5% 1:1
◦ For other pathologies
23. Albumin Fresh frozen plasma
Advantage:
-No risk of hepatitis
-Stored at room temperature
-Allergic reaction are rare
-No concern about ABO bl. group
- Depletes inflammatory mediators
Disadvantage:
-Expensive
-No coagulation factors
-No immunoglobulin's
• Advantage:
-Coagulation factors
-Immunoglobulin's ‘’ beneficial’’ -
factors complement
• Disadvantage:
-Risk of hepatitis, HIV
transmission
-Allergic reaction
-Hemolytic reaction
-Must be ABO compatible
-Citrate load
24. Electrolyte
◦ Obtain serum calcium
◦ Keep calcium level > 8 mg/dl
◦ IV calcium in fusion at a rate of 0.25ml/kg
◦ Monitor s. K & Hco3
Fluid balance:
◦ Usually a volume is given back equal to that removed
unless the patient already severely overloaded.
28. Plasma exchange is accomplished with a medical
device called a blood cell separator.
It uses a centrifuge or membrane plasma filtration to
separate plasma from cellular blood components.
A replacement fluid prescribed is added to replace the
volume of plasma which is removed.
The mix of cellular components and replacement
fluid is returned to the patient.
The blood cell separators accomplish all the above
steps in an automated, continuous, and safe manner.