Changes of colloid osmotic pressure in double filtration plasmapheresis

Serious complications such as pulmonary edema may occur due to a marked decrease in colloid osmotic pressure (COP) secondary to hypoabuminemia in plasmapheresis. It is important to adequate albumin concentration of the substitution solution to avoid hypoal-buminemia in double filtration plasmapheresis (DFPP). In this study, DFPP was per-formed by using substitution solution with either the high concentration (12.5% albumin; group H) and relatively low concentration (5% albumin; group L) for 44 times in 12 patients. COP, concentrtion of total serum protein (protein) and serum albumin (albumin) before, after and at an interval of 15 minutes during DFPP were measured, and compared with the values before DFPP as control. In group L, COP, protein and albumin were significantly lower compared with those before DFPP. In contrast, in group H, COP was significantly lower than control for 45-90 minutes during DFPP, protein was significantly lower 75 minutes and after, whereas albumin significantly increased during and after DFPP. Protein, albumin and COP in group H were also significantly higher than those in group L during and after DFPP, in spite of no significant difference in control values between group H and L. It is concluded from our results that DFPP can be performed more safely by monitor-ing serum COP values and with less change in serum albumin level using substituion solution with relatively high albumin concentration.