Plasmosorption

Plasmosorption is one of the modern methods of extracorporeal hemocorrection, which is based on the process of absorption of pathogenic components from the patient’s blood plasma on the surface of a special sorbent.

For this procedure, special equipment is used, with the help of which, at the first stage, whole blood is pre-divided into cellular elements and plasma.

Further, after passing through the sorption column, the plasma in contact with the sorbent leaves on its surface or in the thickness of the sorbent, substances that cause diseases (atherogenic lipoprotein fractions, circulating immune complexes, pathogenic immunoglobulins). The purified plasma is returned to the patient.

 

The following types of sorbents are used during this type of procedure:

• non-selective (activated carbon)
• semi-selective (ion-exchange resins)
• selective (receptor, immune) sorbents.

 

Indications for plasmosorption are:

• diseases of the cardiovascular system associated with an increased level of lipoprotein (a) (>30 mg/dL).
• contraindications to anti-lipid therapy;
• drug-resistant hypercholesterolemia;
• heterozygous familial hypercholesterolemia;
• prevention of repeated stenosis after myocardial revascularization operations;
• preoperative preparation for transplantation;
• graft rejection reaction;
• pronounced Rh factor incompatible pregnancy;

 

The main contraindications are:

• bleeding in the active phase;
• anemia;
• reduced protein content in blood plasma;
• diseases accompanied by low arterial pressure;
• peptic ulcer of the stomach and 12-duodenum;
• periods.

 

The methodology of the plasmosorption procedure.
Before conducting a course of extracorporeal hemocorrection, the patient must undergo a number of general clinical studies, general and biochemical blood tests, and evaluate the parameters of the blood clotting system.

The calculation of the required volumes of the treated plasma is performed based on the data of the hematocrit, height, weight, and surface area of the patient’s body.

During the procedure, hemodynamics, electrocardiogram, blood oxygen saturation, and the patient’s pulse are constantly monitored.

To ensure the necessary speed of blood flow, during this procedure, the patient is punctured with several peripheral veins, or the central vein is catheterized.

 

Also, during plasmosorption, the following drugs are administered:

• preventing blood clotting in the extracorporeal circuit;
• crystalloid and colloidal solutions to maintain the volume of circulating blood.

The duration of the procedure is several hours and depends not only on the target parameters for the treated plasma, but also on the speed of blood flow in the extracorporeal circuit.