Types of fresh plasma with focus on therapeutic plasma exchange

Tolerance and complications of therapeutic plasma exchange by centrifugation: A single center experience

INTRODUCTION

Therapeutic plasma exchange (TPE) constitutes an important therapy for hematological, neurological, immunological, and nephrological diseases. Most studies have focused on efficacy, whereas tolerance and complications during sessions have been less well studied and not recently.

MATERIAL AND METHODS

We conducted a single center retrospective study of all patients who underwent TPE between 2011 and 2018. TPE sessions using the centrifugation technique were performed by dedicated trained nurses. Specific side effects were identified through surveillance forms completed contemporaneously. The primary outcome was the rate of all-type adverse effects that occurred during the TPE sessions.

RESULTS

In total, 1895 TPE sessions performed on 185 patients were analyzed. At least one adverse effect was reported for 805 sessions (42.5% [29.9%-70.1%]), corresponding to 171 patients (92.4% [87.6%-95.8%]). Hypotension occurred during 288 sessions (15.2%), was asymptomatic in 95.8% of cases, and more frequent with the use of 4% albumin than fresh frozen plasma (FFP) (19.8 vs 8.9%, P <.0001). Hypocalcemia occurred during 370 sessions (19.6%) and was more frequent with the use of FFP than with the use of albumin alone (FFP alone: 28.0%, albumin + FFP: 26%, albumin alone: 11.7%; P <.0001). Allergic reactions occurred during 56 sessions (3%), exclusively with FFP. Severe adverse effects were reported for 0.3% of sessions and 5.4% of patients.

CONCLUSIONS

TPE is a safe therapy when performed by a trained team. Adverse effects were frequent but mostly not serious. The replacement fluid was the main determinant of the occurrence of complications. (ClinicalTrials.gov ID: NCT03888417).

A Critical Review of Recent Progress and Perspective in Practical Denitration Application

Nitrogen oxides (NOx) represent one of the main sources of haze and pollution of the atmosphere as well as the causes of photochemical smog and acid rain. Furthermore, it poses a serious threat to human health. With the increasing emission of NOx, it is urgent to control NOx. According to the different mechanisms of NOx removal methods, this paper elaborated on the adsorption method represented by activated carbon adsorption, analyzed the oxidation method represented by Fenton oxidation, discussed the reduction method represented by selective catalytic reduction, and summarized the plasma method represented by plasma-modified catalyst to remove NOx. At the same time, the current research status and existing problems of different NOx removal technologies were revealed and the future development prospects were forecasted.