Safety aspects of lipidapheresis using DALI and MONET – Multicenter observational study
| Autor: | Wolfgang Ramlow, Frido Himmelsbach, Franz Heigl, Justyna Kozik-Jaromin, Gerd Schmitz, Ingrid Uhlenbusch-Körwer, Jens Ringel, Frank Leistikow, Eberhard Röseler, Ralf Spitthöver, Rainer Heinzler, Nadim Abdul-Rahman, V.J.J. Schettler |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Databases Factual 030232 urology & nephrology Blood count Vascular access Down-Regulation Hyperlipidemias 030204 cardiovascular system & hematology Hematocrit 03 medical and health sciences 0302 clinical medicine Risk Factors Germany Internal medicine Hyperlipidemia Internal Medicine medicine Humans Prospective Studies Triglycerides medicine.diagnostic_test business.industry Cholesterol HDL Cholesterol LDL General Medicine Middle Aged medicine.disease Lipids Severe thrombocytopenia Surgery Treatment Outcome Blood pressure Apheresis Blood Component Removal Female Observational study Adsorption Cardiology and Cardiovascular Medicine business Biomarkers Filtration |
| Zdroj: | Atherosclerosis Supplements. 30:225-231 |
| ISSN: | 1567-5688 |
| DOI: | 10.1016/j.atherosclerosissup.2017.05.036 |
| Popis: | Background Lipidapheresis was introduced for intractable hyperlipidemia as a more selective therapy than plasma exchange aiming to enhance efficacy and limit side-effects. Although this therapy is regarded safe, multicenter data from routine application are limited. We investigated direct adsorption of lipoproteins (DALI) and lipofiltration (MONET) regarding the short and the long-term safety aspects. Methods This multicenter observational study prospectively evaluated 2154 DALI and 1297 MONET sessions of 122 patients during a period of 2 years. Safety parameters included clinical side-effects (adverse device effects, ADEs), technical complications, blood pressure and pulse rate. Also routinely performed laboratory parameters were documented. Analysis of laboratory parameters was not corrected for blood dilution. Results Overall 0.4% DALI and 0.5% MONET treatments were affected by ADE. Technical complications occurred in 2.1% and in 0.8% DALI and MONET sessions, respectively. The most frequent ADE was hypotension, and the majority of technical problems were related to vascular access. Both types of treatments led to a drop of thrombocytes in the range of 7–8%. Hematocrit and erythrocytes decreased only during the DALI treatments by about 6%. Leucocytes decreased during the DALI therapy (∼15%), whereas they increased during the MONET application (∼11%). MONET treatment was associated with a higher reduction of proteins (fibrinogen: 58% vs. 23%, albumin: 12% vs. 7%, CRP: 33% vs. 19% for MONET and DALI, respectively). Apart from severe thrombocytopenia in two DALI patients, changes of other parameters were typically transient. Conclusions Under routine use the frequency of side-effects was low. Still, monitoring of blood count and proteins in chronic apheresis patients is recommended. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect