Evers outlined ways to prevent a hypotensive reaction during preparatory plasmapheresis.
Patient selection: plasmapheresis
Criteria for a severe hypotensive reaction - one or both of the following:
(1) systolic blood pressure <= 90 mm Hg
(2) drop in systolic blood pressure to <= 0.67 of initial systolic blood pressure AND clinical signs (pallor, sweating, loss of consciousness)
Risk factors:
(1) young female
(2) history of hypotensive reaction
(3) hypovolemia during the latter half of procedure (when a large volume of blood is outside of patient's body)
Hypotension can be avoided by infusion of 500 mL of normal (0.9%) saline during and after the procedure (>=250 mL of 0.9% saline during and < 250 mL at the end). Flushing the lines after the procedure can minimize red blood cell loss by the patient.
To read more or access our algorithms and calculators, please log in or register.
