Home Audience 5 Is it possible to do plasmapheresis during menstruation? Plasmapheresis – what is this procedure and when is it necessary. Improving blood flow

Is it possible to do plasmapheresis during menstruation? Plasmapheresis – what is this procedure and when is it necessary. Improving blood flow

Plasmapheresis is a modern therapeutic method of mechanical blood purification through repeated filtration with a special apparatus. This technique is widely used to treat many diseases. Plasmapheresis allows you to cleanse old plasma at the cellular level from toxic substances, defective sex hormones, fats, cholesterol and antibodies.

How is plasmapheresis performed?

The plasmapheresis technique involves centrifuging blood inside a plasma filter, where it is separated into plasma and red blood cells. The process of plasmapheresis occurs as follows:

First, the patient is placed in a chair. A sterile catheter connected to a plasma filter tube is inserted into one of his peripheral veins;
The device starts running a program that determines the required volume of liquid to be withdrawn. Blood is automatically drawn from a vein into a machine where the blood is divided into fractions;
at the end of the procedure (the time of plasmapheresis depends on the therapeutic purpose pursued), the blood, the plasma of which was replaced with a plasma substitute substance or donor plasma, is returned back.

Plasmapheresis is considered the safest method of blood purification among other similar methods. Moreover, its obvious advantage is painlessness, since the blood purification procedure itself is carried out extracorporeally. Plasmapheresis is always supervised by a doctor or nurse who are able to provide timely assistance to the patient if necessary. Yusupov Hospital in Moscow provides medical services the best doctors in the capital, whose professionalism has been repeatedly confirmed by numerous world certificates.

Indications for plasmapheresis

There are a number of diseases, in certain forms of which plasmapheresis is used as complex method treatment. Such diseases include:

hepatitis B and C;
autoimmune infertility;
pregnancy with Rhesus conflict;
otosclerosis;
psoriasis, dermatitis, neurodermatitis;
autoimmune diseases of the body: systemic lupus erythematosus, myasthenia gravis, hemolytic anemia, diabetes mellitus first type, etc.;
endarteritis (Raynaud's disease);
endophthalmitis;
alveolitis, bronchial asthma, sarcoidosis;
chronic inflammatory processes gastrointestinal tract and ENT organs;
herpes;
keratouveitis;
gout;
coronary heart disease;
arthritis, polyarthritis;
thyroiditis;
frequent colds;
toxic damage optic nerve;
allergic reactions of various types;
hypertension;
furunculosis;
chronic viral and bacterial infections;
atherosclerosis of the vessels of the upper and lower limbs, cerebral vessels, retina eyes;
autoimmune ophthalmoplegia.

The course of plasmapheresis is prescribed exclusively by a doctor and ranges from 3 to 5 procedures. A correctly selected treatment method is a decisive factor in the patient’s recovery. The doctors of the Yusupov Hospital, thanks to their high qualifications and many years of work experience, will select an individual course of treatment for each patient, based on his needs and the characteristics of his body.

Contraindications

Despite wide range actions of plasmapheresis, there are a number of indicators that require separate careful consideration by the doctor, or completely exclude this procedure. These factors include:

myopia;
menstruation period;
arterial hypotension;
decreased protein concentration in the blood;
circulatory failure or impaired blood clotting;
purulent-inflammatory processes in acute forms(phlebitis, abscess);
moderate or severe anemia;
hypoproteinemia;
post-infarction period;
the patient has sources of possible bleeding (ulcers).

What to do after plasmapheresis?

Plasmapheresis is a safe procedure, but after it is performed a person may feel somewhat lethargic and tired. For quick recovery vitality must adhere to the following rules:

Plasmapheresis can be tolerated easily by one person, but difficult by others. This depends both on the quality of the procedure and on the individual characteristics of the patient himself. It is important, even if you feel unwell, not to panic, but to simply relax without overloading yourself that day. If symptoms (headache, high blood pressure or temperature) do not go away within a few hours after plasmapheresis, you should consult a doctor. The medical staff of the Yusupov Hospital will ensure that the patient’s recovery after the plasmapheresis procedure is timely and without complications;
On the day of the procedure, you should not overheat or sunbathe on the beach, take hot baths, or go to the sauna or bathhouse, as elevated temperature can cause vasodilation, and, as a result, headaches and dizziness;
Hot foods and drinks should be avoided for several hours after the procedure;
protein diet after plasmapheresis is important factor recovery, since proteins, the main components of cells that support the activity of the whole organism, are washed out of the body along with plasma;
If the patient feels well after the procedure, he can safely return to daily activities.

Plasmapheresis has an excellent temporary effect that can delay the development of autoantibodies or toxins that provoke the appearance of many diseases. Improvement should be expected within a week, depending on the severity of the initial disease and the general condition of the person.

Diet after plasmapheresis

The diet after plasmapheresis should be rich in protein products, since it is foods high in protein, amino acids and healthy fats that have a positive effect on the functioning of the whole body. Alcohol can be taken after plasmapheresis only a week later and in small quantities. Of the possible drinks, you should give preference to dry red wine. Even in ordinary life moderate consumption (up to 100 grams per day) of red wine normalizes the activity of the heart muscle, helps synthesis fatty acids, improves the condition of blood vessels, and also tidies up connective tissues. In other cases, it is not advisable to combine plasmapheresis and alcohol; especially, you should not drink in excessive quantities. After plasmapheresis, you should include the following protein-rich foods in your diet:

meat: rabbit, lamb, beef, chicken (especially sirloin);
eggs;
legumes: beans, peas, lentils, chickpeas and others;
rye and white bread with bran;
soy asparagus;
cottage cheese, kefir, fermented baked milk, hard cheese, yogurt and others fermented milk products;
nuts and seeds: hazelnuts, almonds, cashews, brazil and pine nuts, pumpkin and sunflower seeds, flax and chia seeds;
dried mushrooms;
soy and soy products;
fish and seafood: cod, tuna, trout, sturgeon, tilapia, mullet, sardines, squid, anchovies, mussels, shrimp;
avocado;
peanut butter.

Plasmapheresis is the most effective and efficient method of blood purification, capable of long-term correction of the patient’s general condition and delay the development of microorganisms that contribute to the development of diseases. Plasmapheresis in Moscow is carried out in the leading clinic of the capital - the Yusupov Hospital, which is equipped with the best devices that meet international quality standards. During the consultation, doctors at the Yusupov Hospital will talk in detail about the prospects of this treatment program, and will also select individual treatment based on the patient’s needs. The coordinating doctor will answer all your questions.

References

ICD-10 ( International classification diseases)
Yusupov Hospital
Cherenkov V. G. Clinical oncology. - 3rd ed. - M.: Medical book, 2010. - 434 p. - ISBN 978-5-91894-002-0.
Shirokorad V.I., Makhson A.N., Yadykov O.A. The state of oncourological care in Moscow // Oncourology. - 2013. - No. 4. - P. 10-13.
Volosyanko M. I. Traditional and natural methods prevention and treatment of cancer, Aquarium, 1994
John Niederhuber, James Armitage, James Doroshow, Michael Kastan, Joel Tepper Abeloff's Clinical Oncology - 5th Edition, eMEDICAL BOOKS, 2013

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Membrane plasmapheresis is a method of blood purification used in efferent medicine. Detoxification of the body using technology is indicated for the treatment of a number of diseases and as a preventive measure. The procedure is safe and has a positive effect.

It is based on the separation of blood into liquid plasma and cells using a disposable membrane that acts as a filter. The membrane contains microscopic pores of a certain diameter. Plasma passes through them, and toxins, lipoproteins, harmful chemicals, dead cell debris, and atherogenic lipids remain on the filter.

Efferent medicine includes more than ten methods of extracorporeal detoxification, where blood purification occurs using a device outside the human body. The procedure is relevant and frequently performed.

Indications for this procedure are for patients with:

skin diseases;
hepatitis;
high cholesterol levels;
cholecystitis, diabetes mellitus;
bronchial asthma;
chronic inflammation of the uterus and fallopian tubes;
arthritis;
pancreatitis;
hypertension, cardiac ischemia;
atherosclerosis;
infectious diseases;
allergies;
infertility;
prostatitis;
autoimmune, endocrine diseases;
intoxication of the body.

Hardware plasmapheresis is used for women during menopause, in for preventive purposes before artificial insemination and in case of Rhesus conflict.

The peculiarity of the extracorporeal detoxification method is that it eliminates the risk of the patient contracting an infection or virus during the procedure. Membrane plasmapheresis does not use a donor biological material, the patient’s blood is cleansed and returned to him without toxins through a single highway that has no connections.

Membrane plasmapheresis is a painless operation that cleanses at the cellular level in one course of three sessions:

During the first session, the plasma is cleansed of toxins and freed from the effects of harmful substances. Toxins remain in the intercellular fluid and cells, and over time, poisons penetrate into the blood.
The second session allows you to cleanse the intercellular fluid.
During the third session, the cells are cleansed.

Thanks to deep hardware cleaning, the following effects occur in the body:

detoxification of the blood leads to unloading of organs involved in the elimination of toxins naturally. The functioning of the lungs, kidneys, and liver improves;
liquefaction enhances the performance of the heart muscle. It becomes easier for the heart to pump biological fluid through the vessels;
oxygen starvation is eliminated internal organs and tissues, blood circulation improves;
the delivery of nutrients and the removal of metabolic products from organs is accelerated;
The body's resistance is activated and increased.

Which method is better - membrane or centrifuge?

The detoxification methods used are membrane and centrifugal.

Centrifugal plasmapheresis involves placing a certain volume of blood in a laboratory centrifuge, in which, under the influence of centrifugal force, the lymph is separated from the cells.

Using the centrifuge method, blood is removed in small doses and placed in vials that are sent into a rotating rotor. For a short period of time, the patient is in a state of lack of a certain volume of fluid.

After separating the liquid part of the blood from the cell mass in a centrifuge, the plasma is placed in a plastic bag and sent for purification. The formed part of the blood is divided by the doctor into red blood cells and leukocytes. They undergo a certain procedure: red blood cells are treated with antibiotics, white blood cells - with immunomodulators, which increase the protective activity of the immune system. Under certain physical and chemical conditions, plasma is freed from toxins and harmful components and is poured back into the person the next time the fluid is taken.

Pros and cons of the methods:

During the centrifugation process, slight cell damage is observed, leading to additional stress on the liver and lungs. The advantage of the method is that human plasma is returned in its pure form; with the membrane method, the blood is diluted by more than 20% with physiological solutions.
Another advantage of cleaning using a membrane is the ability to free large volumes of blood from harmful substances in one session, which reduces the procedure time.
The centrifugal purification method is characterized by a low price compared to membrane plasmapheresis. The latter has a low risk of side effects and complications; the cost of the procedure is higher.
During the procedure, infection of the patient is reduced to zero; an individual sterile line is used to perform the procedure, contact medical workers with biological fluid is excluded. With the centrifuge method, the risk of contracting a patient with an infection or virus increases.

The detoxification method prescribed by the doctor depends on the disease, the presence of concomitant pathologies and contraindications. Centrifugal plasmapheresis, used in private clinics and other medical institutions, fades into the background compared to the membrane method.

Review of devices from various manufacturers

Manufacturers have developed and produced many devices for extracorporeal detoxification. The devices are either fully automatic or semi-automatic. The presence of screens, additional sensors and computers affect the cost of the device and the effectiveness of the procedure.

Blood purification units used in efferent medicine:

Devices	Brief description
Hemos	Hemos devices allow for plasmapheresis and hemosorption and can replace expensive devices from imported manufacturers. A distinctive positive characteristic of the machines is the design of venous valves based on the biological device vascular system person. The device weighs 5 kg allows it to be used in various conditions: outpatient; field; stationary; domestic; in an ambulance. Despite its weight, the device is multifunctional and can be used in combination with other disinfection procedures (ultraviolet irradiation, laser cleansing, magnetotherapy). The device is devoid of sections and mechanisms that injure blood cells and damage their integrity. The device does not contain centrifuges, clamps, joints, or infusion pumps. Operates using a disposable pulse pump containing reed valves.
Baxter	The Baxter company is a manufacturer of the system of the same name for extracorporeal detoxification of the body. Baxter plasmapheresis is an automatic system that performs medical and donor procedures for separating blood into plasma and formed part. The device combines centrifugal and filtration methods and is controlled by a microprocessor. The stages of the process are monitored by sensors connected to a computer. The sensors continuously assess the pressure in the vein, helping to regulate the function of the pump to ensure maximum flow of biological fluid into the vein. blood vessel patient. An automated device allows the doctor to monitor a person’s condition without being distracted by the process in the device.
Gemonetic	Haemonetics has produced a line of devices for blood collection, transfusion and detoxification. The Haemonetics PCS-2 device was created by the developers for plasmapheresis. The weight of the machine is about 26 kg, ensuring mobility. The device is automated and equipped with a display for monitoring current processes. PCS-2 has sensors for air, pressure, line tightness, sound and light alarms, and the possibility of emergency interruption of the process with the return of blood to the patient. The device has simple instructions and allows one specialist to control several systems. The patient has the opportunity to independently regulate the speed of blood sampling.

In what cases is the procedure contraindicated?

Detoxification using membrane plasmapheresis is contraindicated for people with peptic ulcers, anemia, a complex form of liver disease, myocardial infarction, or a malignant tumor (with the exception of preparation for cancer therapy using plasmapheresis).

The method of blood purification using the device makes it possible to perform detoxification painlessly and safely for the patient. To carry out the procedure, you need to go to a medical facility.

Depending on what problems most concern a particular person, he is treated differently. Some are waiting for a miracle, trying to restore the former beauty and purity of the skin, since they consider it to be a very effective (and safe!) means of rejuvenation, others call it a “drug first aid”, because it cleanses the blood of the breakdown products of ethyl alcohol, and still others place their last hope for a cure. a serious illness that has been bothering me for many years. Indeed, probably the most common intensive method of purifying the blood from pathological substances (toxins, circulating immune complexes - CEC, antibodies unnecessary to the body, mediators inflammatory reactions etc.), is plasmapheresis (plasmacytopheresis). Being widely used in various fields of medicine, therapeutic plasmapheresis is the division of blood into components (formed elements + liquid part) with further replacement of defective plasma.

In addition to plasmapheresis, in practice, both therapeutic and surgical, other methods of extracorporeal blood purification are used, for example, hemodialysis, lymphosorption, hemo- and plasmasorption, drainage of the thoracic lymphatic duct. However, almost as effective as other procedures of this kind, among the listed methods, plasmacytopheresis is noticeably superior, since it is characterized by the greatest accessibility, almost absolute safety, ease of implementation, less trauma and relatively low cost.

What is plasmapheresis?

Besides therapeutic plasmapheresis, the purpose of which is to cleanse the blood of harmful substances, there is another type - donor plasmapheresis, designed to obtain such valuable remedy, like plasma: fresh frozen or immune, obtained from donors after they have been immunized and developed antibodies to a specific antigen (staphylococcus, tetanus, etc.). But if a patient who undergoes this procedure and works only with his own blood receives his (or part of it) back, then in cases of donor plasmapheresis, only the formed elements are returned to the person who gave the blood (donor), and the lost liquid part, so as not to BCC decreased and is replaced by plasma-substituting solutions. Plasma is frozen and quarantined for subsequent transfusion to sick people or becomes raw material for the production of blood products (albumin, cryoprecipitate, etc.). Of course, it is impossible to extract all the plasma from a donor, therefore plasmapheresis, carried out in blood service institutions for the purpose of procuring this valuable biological fluid, is a strictly regulated procedure. Thus, as a result of double plasmapheresis, which is the most common, 500–600 ml of plasma can be obtained from a person donating his blood.

Of course, it is impossible to separate plasma from formed elements with “bare hands,” that is, without the use of certain equipment. Depending on which method was used to obtain the liquid part, there are types of plasmapheresis:

Sedimentation(settling method), which, in general, has become obsolete, since it does not make it possible to carry out volumetric plasmapheresis, because spontaneous sedimentation of formed elements requires quite a long time;
Centrifugal(gravity) – convenient for obtaining donor plasma, as well as for carrying out this procedure in medicinal purposes, if another method is unavailable for some reason, since it does not require any special equipment (it is enough to have a refrigerated centrifuge and plastic containers - hemacons);
Membrane(plasmafiltration);
Hardware.

I would like to dwell on the last two types and describe them in more detail, since these are the best, but, unfortunately, not so available methods blood purification.

Membrane and hardware plasmapheresis

About instrumental plasmacytopheresis in Russia (then the USSR) they learned at the turn of the 60-70s of the last century, when it became possible to obtain blood components by automatic separation using devices - blood cell separators, which allow the procedure to be carried out in two ways depending on the type of separator: with continuous, in-line cell separation blood and with intermittent, semi-flow separation. It would seem that the new model of plasmapheresis will completely satisfy the existing problems, but in reality everything turned out to be not so simple. Compliance with the principle of “one patient – one device” and high cost not only foreign equipment, but also domestic analogues, and hence their scarcity, as well as other circumstances, raised their own questions.

The situation is similar with membrane plasmapheresis(in Russia similar procedure debuted in the mid-70s). Membrane plasmacytopheresis is the “purification of blood” by filtering it through disposable fiber (membrane) filters. These filters allow you to separate plasma in which pathological elements are concentrated (toxins, harmful biologically active substances, fragments of cell walls, “bad” cholesterol). Equipment designed for such purposes operates automatically, has a device that allows you to control the progress of the procedure, and the process itself resembles hemodialysis.

Of course, the participation of high-tech equipment cannot be cheap, which affects the cost of treatment for the patient himself or for medical institution, who took on the costs.

The main task of membrane plasmapheresis is detoxification. Indications for the procedure are:

Inflammatory processes localized in abdominal cavity and chest (acute period);
Infectious diseases;
Burns;
Severe injuries;
Poisoning.

In such situations, it is greatly depressed immune defense with the development of a kind of “immune distress syndrome”. Detoxification in such cases allows you to suppress the disease to some extent and direct the patient’s body towards recovery.

In this regard, it is also appropriate to mention such a method as cascade plasmapheresis, which was developed in the 80s of the last century. It involves re-passing plasma through special microporous filters that can not interfere with the passage of proteins with low molecular weight (albumin, for example), but retain large molecules of low and very low density lipoproteins (“bad” cholesterol), which are the cause of the development of the atherosclerotic process. In addition, clinicians note high efficiency cascade plasmapheresis for other serious pathological conditions: multiple myeloma, severe lesions liver and kidneys, hematological pathology, collagenosis and many other diseases that cannot be treated with traditional methods.

Of course, both membrane and hardware plasmapheresis are mainly the privilege of large specialized clinics, where they are used to treat patients with severe pathology. Meanwhile, it cannot be said that patients living in small populated areas and those in need of treatment (blood purification) are completely deprived of the opportunity to receive it. In such cases, blood purification with extraction of at least 1.5 liters of plasma is carried out in a simpler and cheaper way - centrifugal.

What is the purpose of plasmapheresis?

What does not enter the human body from the external environment: exhaust gases, tobacco smoke, toxic substances in the form of waste thrown out by industrial enterprises and much more, as well as medicines, alcohol-containing liquids and drugs that people use in most cases on their own initiative. Can you imagine how the main life support organs suffer: heart, liver, lungs, kidneys? They receive a colossal load, which, moreover, affects the functioning of such important systems as the nervous, endocrine, and immune systems.

As for unhealthy people, the situation here is even worse: exposure to harmful factors only aggravates the course of the underlying disease, so blood purification in such cases becomes a priority. And then a safe, practically painless procedure of plasmapheresis comes to the rescue, which is used not only for rejuvenation and healing of the body, lifting vitality and mood, but also for the treatment of more than two hundred diseases.

In general, the following tasks are assigned to plasmacytopheresis:

Remove various harmful substances from the circulation: toxins, mediators of inflammatory reactions, paracoagulation products, namely, pathological antibodies, CIC (circulating immune complexes);
Replace “bad” plasma, in which there is either a lack of normal components (blood clotting factors, immunoglobulins) or an excess of pathological antibodies;
Bring the BCC (circulating blood volume) and rheological properties of blood to normal with further improvement of blood circulation in the microvasculature.

The reader can get acquainted with all the indications for blood purification in the next section.

Figure: normal plasma composition:

Indications

Based on many years of experience, which has revealed the undoubted benefits of plasmapheresis, clinicians rightfully consider blood purification in some cases the procedure is mandatory, for example:

Paraproteinemic hemoblastoses:
Goodpasture's syndrome (systemic capillaritis with damage to the lungs and kidneys);
GBS (Guillain-Barré polyradiculoneuritis);
(in the absence of effect from glucocorticoids);
DCT (diffuse connective tissue diseases) or diseases that are usually called collagenosis (RA).

Plasmacytopheresis stimulates the immune system, increases defenses and thus helps the body fight viral and bacterial infection. At the same time, blood purification reduces the risk of developing allergic reactions or prevents them altogether. That's why indications for the blood purification procedure (other than those indicated above) are:

Skin lesions (psoriasis, dermatitis, eczema, Lyell's syndrome);
Inflammatory processes affecting the gallbladder, liver parenchyma and pancreas;
Ulcerative colitis and Crohn's disease;
Amyloidosis;
Multiple myeloma;
Pathology of the thyroid gland;
Bronchial asthma;
Elimination of the consequences of chemotherapy and radiation therapy;
Previous hepatitis B or C (membrane plasma filtration allows you to remove pathological substances - metabolites, autoantibodies);
Diabetes mellitus (prevention of secondary complications);
Infections, chronic inflammatory diseases female genitalia, infertility, miscarriage, late toxicosis, prevention of Rh conflict, preparation for IVF (in vitro fertilization);
APS (antiphospholipid syndrome);
Heart and vascular diseases: ischemic heart disease, arterial hypertension, atherosclerotic process;
Allergic reactions, autoimmune diseases, infections;
Diseases genitourinary system in men (urethritis, prostatitis);
Hemolytic-uremic syndrome;
Multiple organ failure;
Glomerulonephritis with nephrotic syndrome;
CFS (chronic fatigue syndrome);
Intoxication (including drugs and alcohol).

In addition, blood purification is often prescribed if previously carried out measures were not successful, and in some situations this treatment(“blood cleansing”) is generally perceived as an element of resuscitation, for example, in case of sepsis, acute intravascular hemolysis, and also after a person has experienced clinical death.

Not strictly, but...

Meanwhile, although not strict, although not absolute, but some There are still contraindications to plasmapheresis. This:

Chronic IDA (iron deficiency anemia), when the hemoglobin level does not rise above 90 g/l;
Serious lesions of the liver parenchyma, leading to disturbances in protein synthesis (values total protein the blood test does not reach 60 g/l);
Tumor process (however, if membrane plasmapheresis provided for in the preparation protocol for surgical intervention, then the procedure is not cancelled);
Edema syndrome;
Exacerbation peptic ulcer stomach and duodenum;
Problems with venipuncture caused by congenital anomaly the structure of veins or vascular lesions formed as a result of numerous intravenous injections;
Acute period cardiovascular diseases, for example, myocardial infarction up to six months;
Unstoppable bleeding.

Considering that medicine does not note any absolute contraindications to this procedure, the issue is considered individually in each case and, if the patient’s condition, his age and the nature of the course concomitant pathology allows, then, as a rule, doctors are inclined towards blood purification.

Benefits of plasmapheresis

The benefits of plasmapheresis are undeniable, because the body receives treatment and gets healthier without the use of synthetic drugs, thanks to its own resources. However, I would like to explain in more detail what positive effects it brings this procedure, that is, what are the benefits of plasmapheresis. So:

Plasmapheresis solves the problem of detoxification. Everything that has become superfluous in the body, but is concentrated in the blood, intercellular space and tissue cells (harmful biologically active substances, toxins, fragments of viral particles, remains of dead cells, etc.) leaves along with the removed plasma, which provides rest for the organs that are usually occupied with such work (liver, kidneys, lungs);
Plasmapheresis improves the rheological properties of blood. A wide range of pathological conditions in which the blood thickens (in a blood test: the hematocrit is increased, the hemoglobin level is increased) strains cardiac activity and disrupts blood flow in the microvasculature (it is difficult for blood to overcome the narrow lumen of the vessel), which leads to chronic oxygen starvation (hypoxia). Lack of oxygen and nutrients, tissues accumulate what they could not give away - toxic metabolic products. Blood plasma, passing through a filter (membrane plasmapheresis), leaves harmful substances accumulated in the body, and is itself renewed. As a result, blood viscosity decreases, fluidity improves, and hematocrit values return to normal. Of course, renewed blood will “run” through the vessels faster and reach the most remote corners human body to provide tissues with oxygen and nutrients and take away the products of exchange from them.
Membrane plasmapheresis plays the role of an immunomodulatory factor. Pathological immunoglobulins and autoantibodies present in plasma that support chronic inflammation, will not be able to overcome the filter membranes and will settle on them, therefore, blood purification will help the immune system restore its lost balance. In addition, perceiving the filter and lines of the device as something foreign, the immune system begins to activate, thereby increasing the body’s defenses.

Meanwhile, patients who are prescribed a similar procedure are interested in the harm of plasmapheresis. If plasmacytopheresis is carried out correctly, the extracted plasma is adequately replaced (with intermittent plasmapheresis) with saline or colloidal (if the volume exceeds 1.5 l) solutions, then, in addition positive effects Blood purification does nothing. Another thing is the complications and reactions that can accompany any treatment. For example, hemodynamic disturbances such as fainting (in isolated cases - orthostatic collapse), as well as temperature reactions. However, all this can be easily stopped and is not a serious obstacle to further carrying out the procedure. In the process of treatment, an exacerbation of chronic diseases that the patient has, for example, sinusitis, is possible, because immune system comes out of hibernation. However, this can hardly be called a harm of plasmapheresis...

An integrated approach to the treatment of alcohol or drug addiction involves blood purification - plasmapheresis. The functions of the patient’s internal organs change over time, and the liver can no longer cope with the elimination of toxic substances on its own. Thus, with alcoholism, insufficient production of the enzyme alcohol dehydragenase, whose task is to break down ethyl alcohol. Hardware blood purification allows you to get rid of poisons and alleviate withdrawal symptoms.

The essence and methodology of plasmapheresis

With plasmapheresis, the blood is separated into its components using a centrifuge, its liquid part is filtered, and the cellular elements are returned to the circulatory system. The procedure differs from hemodialysis in that natural fractions of blood are released, and not just substances that are dissolved in it.

Catheters are inserted into the patient's arm veins and tubes are connected to a plasma filter, inside of which pumps, centrifuges, membranes and filters are installed. 400-500 ml of blood enters the apparatus, which separates it into the liquid component and cells (leukocytes, erythrocytes, platelets). The plasma can be disposed of, or it can be purified through a filter and returned to the bloodstream.

The doctor assesses the patient’s condition and prescribes a course that includes 1-12 procedures. Quantity depends on physical condition patient. Each session lasts 1-2 hours. The duration is influenced by several factors: the characteristics of the disease, the type and performance of the device, the amount of blood taken.

Throughout the entire therapeutic session, the doctor monitors the patient’s blood pressure, pulse, general condition and well-being. If necessary, provides medical care. To completely eliminate hangover syndrome, get rid of painful headaches, nausea and vomiting, a few sessions are enough.

Indications and contraindications for plasmapheresis

Initially, the procedure was used at transfusion stations for separation and preparation donated blood. Now this is a popular therapeutic technique, as it can improve the condition of patients by removing substances that cause pathological processes. Its effectiveness has been proven in the treatment of addictions, severe autoimmune diseases, and serious poisonings.

When are procedures prescribed?

It should be understood that the procedure itself is not therapeutic. This is an auxiliary therapeutic technique. It removes toxic and ballast elements, has a positive effect on the body, stimulates the immune system and allows you to achieve more significant results with complex treatment.

Contraindications to plasmapheresis

During the procedure, part of the blood is taken from the circulatory system, which does not always have a positive effect on the body. In the list of contraindications:

Anemia. When hemoglobin is less than 80 g/l, all organs and systems experience oxygen starvation. In this case, it is better to abandon the course, as it may worsen the situation.
Low concentration of total protein. The permeability of vessel walls depends on proteins in the blood. If the concentration is less than 60 g/l, plasmapheresis may cause high blood pressure and various water-electrolyte balance disorders.
Diseases associated with circulatory failure. If you have problems with the cardiovascular system or have recently had a heart attack, plasmapheresis cannot be performed.
Bleeding. In case of serious blood loss, you should not resort to techniques that can worsen the situation.

Plasmapheresis of blood is used to rid it of toxins or reduce the number of other components, for example, red blood cells, platelets, and leukocytes. Mechanical filtration can be either therapeutic or donor. In the first case, after purification, the blood is returned back to the patient, in the second, it is frozen for temporary storage.

For therapeutic purposes, plasmapheresis is used if necessary. quick fix intoxication, inflammatory processes, normalization of metabolism, when it is necessary to maintain a certain blood composition or create one before surgery.

What is this procedure

Answering the question of what is plasmapheresis, it should be noted that it differs significantly from hemosorption, which is also used for blood purification. During plasmapheresis, it is collected and divided into fractions; during the second procedure, treatment is carried out using sorbents.

There are therapeutic and donor plasmapheresis. The first is used to normalize the patient's condition in various acute and chronic conditions.

The collected blood is divided into formed elements (leukocytes, platelets, erythrocytes) and plasma, consisting of saline solutions, protein and other compounds.

After cleaning, the missing liquid is poured back into the patient, replacing the damaged “dirty” part. The donor procedure involves the collection and storage of plasma for subsequent administration to people in need.

In general, the task is to normalize the volume of circulating blood components, remove toxins, paracoagulation products, mediators of inflammatory processes, and transport missing coagulation elements and immunoglobulins into the body.

Effect

When completing the course (from 2 to 6 sessions), the patient feels a significant improvement in his condition. This is explained by the fact that when the blood composition is normalized, the organs begin to function better, feeding only on a healthy environment.

In addition, when cleansing the body, a response occurs and protective reactions are mobilized, in other words, immunity increases.

How does the procedure work?

During treatment, it is recommended to undergo at least 3 sessions. At the first stage, only substances circulating in a free state through the bloodstream are eliminated. At the second stage, products from the intercellular fluid become available. And in the third session, all pathogenic substances of the cells are eliminated.

At one time, you can remove a quarter of the total volume of plasma, of the total amount of blood this will be an eighth. The exact amount is determined by the weight and age of the patient.

Stages of implementation

Plasmapheresis can be carried out either through 1 or 2 catheters.

The significant difference is that in the first case, the collection occurs first small dose, then cleaning, and then returning the processed substance. In the second option, the process is continuous; blood is drawn through one catheter, and then immediately reintroduced through a second catheter in the other arm.

The collection involves pumping out a certain volume of blood along with all toxins, viruses, bacteria, cholesterol and shaped elements. In this case, the patient is conscious, in a lying or semi-sitting position. The catheter is inserted into the cubital vein.
The blood is divided into fractions as it passes through the device.
The plasma is completely pumped out, and the remaining suspension is saturated with saline, glucose, potassium chloride, albumin, and rheopolyglucin.
The resulting mixture is delivered back to the patient's body.

Types and classification

According to the method of implementation, hardware and discrete types are distinguished. There are therapeutic and donor types according to purpose.

According to the treatment method, plasmapheresis can be:

Centrifugal or gravity. Hemofenix device for high speed rotation of the drum separates the blood into fractions. Since this method severely damages cells, it is used very rarely.
Membrane or plasma filtration. It has virtually no contraindications and takes a minimum of time; the cells are not damaged during the cleaning process. A device with pore filters is used.
Sedimentation or settling method. It is one of the cheapest and is rarely used. In this case, the blood is not subjected to hardware processing, but is only left to settle for a certain amount of time. This method does not allow cleaning large volumes, so the range of applications is small.
Cascade plasmapheresis. Indicated when severe conditions autoimmune patients, and is also used in surgery and resuscitation. The main difference is double way cleaning. First, the cell part is filtered, then the plasma. The disadvantage is the high cost of manipulation.
Cryoplasmapheresis. The collected blood is frozen at low temperatures, and then heating and centrifugation. The settled part is not used. Area of application - elimination of the consequences of severe poisoning and, as a consequence, intoxication.

Indications

Plasmapheresis is used to remove substances that provoke a pathological process from the body.

Treatment is prescribed for:

The need to urgently rid the plasma of toxins and metabolic elements caused by autoimmune diseases or inflammatory processes. For example, when rheumatoid arthritis, asthma, sclerosis, hypertension, neuropathy.
The need to maintain a certain blood composition for a long time. In this case, only one link in the pathogenesis is excluded. Typically, indications for use are Rh-conflict, diabetes, viral hepatitis, in the process of treating oncological pathologies, poisoning with poisons, toxins of bacterial origin.
Preparation for surgery if the primary composition is unacceptable for surgical intervention.

In general, mechanical blood purification can be used in complex therapy at:

Multiple myeloma.
Extensive destruction of red cells in blood vessels.
The presence of free myoglobin in the blood.
Hemoglobinopathies.
Myasthenia.
Gasser's disease, Crohn's.
Porphyria.
Intoxication with chemical poisons.
Rheumatism.
Viral myocarditis.
Asthma, chronic pneumonia.
Ulcerative colitis.
Endocrine pathologies, in particular diabetes.
Peritonitis, sepsis.
Significant burns.
Organ rejection after transplantation.
Herpes, psoriasis.
Glomerulonephritis.
Allergic encephalitis.
Vasculitis.

Contraindications

In some cases, even a useful procedure can lead to a deterioration in the patient’s well-being, so it is not recommended for:

Anemia when hemoglobin is less than 80 g/l. If you resort to manipulation in this case, oxygen starvation will increase.
Bleeding of any nature.
Conditions when the body does not have enough blood. Usually this list contains pathologies cardiovascular systems s, as well as ulcer and post-infarction interval.
Reduced amount of protein in the blood (less than 60 g/l). This indicator is responsible for the permeability of the walls of blood vessels and the level of the liquid component of blood inside them. If the value deviates from the norm, the procedure disrupts the water-electrolyte balance and increases blood pressure.
Death of cerebral vessels due to circulatory disorders.
High blood pressure.
Liver dysfunction.
Heart diseases.

All contraindications can be:

Absolute when there is significant damage to the brain, heart, liver, lungs, kidneys or severe bleeding.
Relative. These include blood diseases, when the risk of extensive bleeding is increased, and conditions that provoke bleeding. For example, ulcers, hypotension, pregnancy, menstruation, infectious diseases.

It is also better to refuse manipulation if you are allergic or if negative reactions to blood transfusions have previously been observed.

Benefits and harms of the procedure

Plasmapheresis is rarely performed as the only means of treating a patient; it is usually an auxiliary measure, which explains its success.

The advantages of choosing a method include:

Detoxification. Getting rid of toxins occurs by “washing” blood cells. In fact, differential assessment helps to separate factions from harmful substances, and return useful ones back into the bloodstream.
Stimulation of the hematopoietic and cardiovascular systems on the reflex plane. At the same time, the body is in the recommended water and electrolyte balance. When the need arises, solutions that replace it can be injected into the bloodstream instead of plasma.
Immunomodulation. Contact of blood with the structure of plasma filters irritates immune cells, which helps improve their performance. But when autoimmune diseases this may have the opposite effect, since the action of tissues against one’s own body will increase and this will cause an exacerbation of the disease. Therefore, the treatment of such pathologies requires constant medical supervision.

Harm from the procedure may be completely absent, minimal, or, with certain characteristics of the body, lead to the death of the patient. To minimize side effects, the doctor must fully examine the patient before plasmapheresis and prescribe treatment only for serious indications.

In most cases, everything is limited to headache, nausea and a surge in blood pressure, which is explained by the body’s reaction to extreme conditions and does not pose a serious threat. At the same time, it may develop allergic reaction, including an autoimmune nature from the renal apparatus to donor plasma.

In addition, blood cleansing involves the removal of both harmful and beneficial components, which can temporarily weaken the immune system. If performed incorrectly and with incompetence of personnel, there is a high risk of infection, blood clots, sepsis, and metabolic disorders.

Possible complications

Even with a favorable picture of the examination before the procedure, during the process the body may react negatively to the manipulations performed.

Most often, patients experience the following complications:

Hypotension. A sharp decrease in blood pressure can cause oxygen starvation. In severe cases, this results in disability or death.
Anaphylactic shock. Allergic manifestations include hemodynamic changes, chills, autonomic disorders. If not treated promptly, it can lead to death.
Extensive internal bleeding. That is why, in case of an ulcer or erosive areas on the mucous membranes of the gastrointestinal tract, it is better to refuse the procedure.
Citrate intoxication, in which the patient can fall into a coma, which ends in death. Fortunately, these are isolated cases.

If you feel unwell, you must interrupt the procedure. If this happened outside the walls of a medical institution, immediately consult a doctor or call an ambulance.

Preparation for the procedure

To reduce the risk of complications from manipulation, special preparation is recommended before performing it.

To do this you need:

Normalize proper nutrition, stick to a high protein diet, but reduce your intake of phosphorus, potassium, and sodium.
Get enough sleep and drink plenty of fluids the night before plasmapheresis.
Stop smoking.
Get a medical examination.

The therapist examines the patient, measures blood pressure, prescribes a clinical and biochemical blood test, determination of glucose, Wasserman reaction, RW, coagulogram, ECG.

Carrying out during pregnancy

The procedure is useful in preparing for conceiving a baby, especially for women who have smoked a lot before. This method helps remove cigarette poison.

During pregnancy, plasmapheresis may be indicated for severe toxicosis. There will be improvements within a couple of sessions.

In addition, during pregnancy the risk of intrauterine infection decreases, oxygen starvation fetus, oligohydramnios and extensive bleeding during childbirth.

How long does one session and course last?

On average, one session lasts 1.5 hours. Plasmapheresis can be repeated after 3-4 days.

For therapeutic purposes, the time increases, the duration of the procedure reaches 2-3 hours, and the frequency is 4-5 times a week. The course includes 3-6 sessions. The number of procedures is selected individually depending on the severity of the disease and the characteristics of the disease. You can undergo treatment again after six months.

Plasmapheresis device

Devices can be portable or stationary. The first ones are convenient because they can be installed anywhere without disturbing the patient’s peace, even at home if necessary. There are devices that first take a small portion of blood, purify it and return it back.

Such devices pump 100-150 ml of biological fluid per minute. Others contain 2 catheters, so that they can be taken out through one and immediately returned through the other. In this case, the device does not stop the process.

The plasma filter contains centrifuges, membranes, pumps or filters. It all depends on the choice of method.

Price

The price for one session is very different and can range from 2,000 to 60,000 rubles. The cost depends on the chosen treatment method, the reputation of the clinic, the experience and competence of the doctor. The region is also of considerable importance: the closer to the center of the capital, the more expensive.

Thanks to the availability various methods, each patient can choose the right method, focusing on its price. We should not forget that one procedure is usually not enough; at least three are performed.

Application of the method for disease prevention

Despite the fact that the benefits of this manipulation are significant, plasmapheresis is a serious intervention in the structures of the body.

When it is performed, a significant part of the blood is taken, its structure and formula changes, certain elements are extracted or destroyed. It takes a lot of time to replenish them.

In addition, all organs feel a lack of intercellular fluid when plasma volume is restored. According to most experts, such a load on the hematopoietic system and the body as a whole for the purpose of prevention is not justified.

Efferent therapy methods help restore disturbances in homeostasis. Plasmapheresis is also a type of this group. Its advantage is that you can quickly remove toxins and normalize the desired blood composition.

Despite all the advantages, it is not worth resorting to the procedure for prevention, as this is a considerable stress for the body. To avoid complications, the patient is carefully examined before the procedure, and pressure indicators and the functioning of vital systems are monitored during the process.