MEDICAL AND ECONOMIC ANALYSIS OF THE CHOICE OF THERAPEUTIC PLASMAPHERESIS METHOD TO OPTIMIZE THE TRANSFUSION CARE QUALITY

The aim: To analyze the medical and economic aspects of the manual and different types of automatic plasmapheresis (manual, automatic centrifugal, automatic membrane, plasmapheresis with plasma therapy and mixed) used for therapeutic purposes. Materials and methods: The Baxter Auto-C, Haemonetics PCS2, Haemophenics, Baxter CPDA anticoagulant and saline, Baxter 16GA needles were used. Total protein was examined by the biuret method, hemoglobin by the Sally method, total bilirubin by the colorimetric photometric method, cell fragments by the Goryaev camera microscopy method; patient comfort - with a 10-point scale. Healthy blood donors participated in the study. Manual plasmapheresis was performed in 31 people, automatic plasmapheresis with centrifugal technology - 36 people, with membrane technology - 21 people, mixed technology - 36 people. Results: An analysis of the different technologies impact on hematological, psychological and medical and economic indicators was performed. Native hemoglobin was absent in the bloodstream and in the final plasma with all technologies. Bilirubin index was within normal limits. There were no cell fragments. It was proved the absence of significant differences in various technologies on hematological parameters. The lower level of patient comfort by manual plasmapheresis was established. Conclusion: All therapeutic plasmapheresis technologies have the same effect on the patient's blood hematological parameters and did not have a negative impact on the body by the indicators: hemolysis, the presence of cell fragments, patient discomfort and citrate reactions during the standard procedure of sampling 800 ml of plasma. The most effective are plasmapheresis machines with centrifugal technology by medical and economic parametres.