Applicazione clinica della plasmaferesi : problemi tecnici

The authors discuss the plasmapheresis method and its main complications observed in 25 treatments in 17 poisonings by Amanita Phalloides. The authors suggest the substitution of the plasma removed by patients with frozen plasma. If requested it is possible to use Human Albumin 5% in normotonic balanced saline solution in the first three cycles. The main complications observed were: hyperhydration, due to incorrected evaluation of water balance or to hypoalbuminemia which was present before treatment; difficulty in arterial haemostasis when arterial indwelling was used; tetania, due to ACD excess; and anaemic anossia, due to transitory anaemia during treatment. The treatment is safe, simple and valuable when the following points are respected: careful evaluation of circulatory and respiratory state; safe and efficient withdrawal; and prompt and accurate replacement of removed blood volume.