DFPP療法における安全性とその留意点(<特集>アフェレシスにおけるセイフティーマネジメント) 江口 圭 平山 千佳 横井 良 金子 岩和 峰島 三千男 秋葉 隆 日本アフェレシス学会 日本アフェレシス学会雑誌 13405888 24 1 39 46 2005-02-28 Double-filtration plasmapheresis (DFPP) has been widely used clinically as apheresis therapy for various autoimmune diseases, blood-group-incompatible renal transplantation, familial hypercholesterolemia, arteriosclerosis obliterans, etc. DFPP is procedurally complicated, as compared to hemodialysis, because it is designed to separate plasma components in two stages. A firm knowledge and fixed technique are required for safe execution of the treatment. Unless the albumin concentration in the substitute fluid is adequate, for instance, there is the risk of hypotension and cardiac overload, due to a decrease of the colloid osmotic pressure. Unless the amount of substitute fluid handled is adequate, efficient removal of pathogenic substances cannot be expected. The method of administering anticoagulants also needs to be altered according to the treatment indication. It is important to establish proper treatment conditions tailored to individual patients. This article describes the importance of a control and monitoring system as safety management of the apparatus and the establishment of proper treatment conditions (substitute fluid, anticoagulants, etc.) for the safety of the staff involved with the treatment. 2005-02-28 110003161377 AA11604174 JPN NII-ELS 1 Safety Management of the DFPP Treatment Eguchi Kei Hirayama Chika Yokoi Ryo Kaneko Iwakazu Mineshima Michio Akiba Takashi Japanese Society for Apheresis Japanese journal of apheresis Double-filtration plasmapheresis (DFPP) has been widely used clinically as apheresis therapy for various autoimmune diseases, blood-group-incompatible renal transplantation, familial hypercholesterolemia, arteriosclerosis obliterans, etc. DFPP is procedurally complicated, as compared to hemodialysis, because it is designed to separate plasma components in two stages. A firm knowledge and fixed technique are required for safe execution of the treatment. Unless the albumin concentration in the substitute fluid is adequate, for instance, there is the risk of hypotension and cardiac overload, due to a decrease of the colloid osmotic pressure. Unless the amount of substitute fluid handled is adequate, efficient removal of pathogenic substances cannot be expected. The method of administering anticoagulants also needs to be altered according to the treatment indication. It is important to establish proper treatment conditions tailored to individual patients. This article describes the importance of a control and monitoring system as safety management of the apparatus and the establishment of proper treatment conditions (substitute fluid, anticoagulants, etc.) for the safety of the staff involved with the treatment. 江口 圭 Eguchi Kei 東京女子医科大学臨床工学部 Department of Clinical Engineering and Tokyo Women's Medical University 平山 千佳 Hirayama Chika 東京女子医科大学臨床工学部 Department of Clinical Engineering and Tokyo Women's Medical University 横井 良 Yokoi Ryo 東京女子医科大学臨床工学部 Department of Clinical Engineering and Tokyo Women's Medical University 金子 岩和 Kaneko Iwakazu 東京女子医科大学臨床工学部 Department of Clinical Engineering and Tokyo Women's Medical University 峰島 三千男 Mineshima Michio 東京女子医科大学臨床工学部 Department of Clinical Engineering and Tokyo Women's Medical University 秋葉 隆 Akiba Takashi 東京女子医科大学腎臓病総合医療センター血液浄化療法科 Division of Blood Purification, Kidney Center, Tokyo Women's Medical University