PE療法におけるセイフティーマネジメント(<特集>アフェレシスにおけるセイフティーマネジメント)  [in Japanese] Safety Management for the Critically Ill Patients Treated with Plasma Exchange  [in Japanese]

Plasma exchange (PE) is one of the most important apheresis therapies for the critical illness, such as fulminant hepatitis, thrombotic thrombocytopenic purpura (TTP), severe hemolytic uremic syndrome (severe HUS) and autoimmune disease. We have established slow plasma exchange plus continuous hemodiafiltration (SPE plus CHDF) that can overcome adverse effects such as hypernatremia, metabolic alkalosis and abrupt drop in colloid osmotic pressure (COP), which may develop when conventional PE alone is performed. SPE plus CHDF has been safely performed on the patients with critical illness mentioned above. However, there still is a possibility that incidents or accidents would be occurred because SPE plus CHDF has an extracorporeal circulation. We studied a safety management for the patients treated with SPE plus CHDF in ICU. We have to consider the risks from all aspects such as patients, medical appliances and medical staff, and have to establish the completely safe management of patients when they are treated with SPE plus CHDF.