Abstract
We performed plasma exchange (PEx) and double filtration plasmapheresis (DFPP) on 4 patients, 2 HB-nephropathy, 1 amyotrophic lateral sclerosis (ALS) and 1 progressive systemic sclerosis (PSS). And we investigated various cardiovascular parameters via Swan-Ganz catheter on four occasions in each case: before and at 1 hour and 2 hours after initiation of PEx and DFPP and at 30 minutes after completion of them. In 2 HB-nephropathy and 1 ALS, all cardiovascular parameters were within normal limits. But in PSS, systemic vascular resistance (SVR) increased significantly before PEx and DFPP. In the patients except PSS, mean pulmonary -arterial pressure (PAP), cardiac index (CI) and stroke work index (SWI) decreased significantly -during DFPP than PEx, but SVR increased significantly during DFPP. And so mean arterial pressure (MAP) did not decrease significantly at 2 hours after initiation of DFPP and at 30 minutes after the completion. In PSS, PAP, CI and SWI decreased significantly during DFPP than PEx, but SVR did not increase, so that MAP decreased during DFPP significantly. These facts suggested that DFPP has more influence upon the hemodynamics than PEx, because of decreased plasma refilling rate during DFPP. It is important of grasp sufficient information on the cardiovascular dynamic status at the time of DFPP on the patients with systemic vascular disease.
