PMID- 26267518
OWN - NLM
STAT- MEDLINE
DCOM- 20160314
LR  - 20220408
IS  - 1537-2995 (Electronic)
IS  - 0041-1132 (Linking)
VI  - 55
IP  - 11
DP  - 2015 Nov
TI  - Acid-base balance disturbances in plasma exchange depend on the replacement fluid 
      used.
PG  - 2653-8
LID - 10.1111/trf.13215 [doi]
AB  - BACKGROUND: Metabolic alkalosis occurs as a direct result of plasma exchange (PE) 
      because of metabolism of citrate. However, we observed a decrease of serum pH and 
      bicarbonate after PE when albumin was used as replacement fluid. STUDY DESIGN AND 
      METHODS: The acid-base balance in 2730 PEs using different replacement fluids 
      (albumin, fresh-frozen plasma [FFP], or both) was measured, and absolute changes 
      (Delta) in acid-base balance were compared. The frequency of adverse effects (AEs) 
      before and after using prophylactic administration of sodium bicarbonate was 
      compared. RESULTS: A decrease of serum pH and bicarbonate was observed after PEs 
      when albumin was used as replacement fluid (Delta pH = -0.06 +/- 0.04; Delta bicarbonate = 
      -4.03 +/- 2.29 mmol/L; Delta base excess = -2.54 +/- 3.82 mmol/L). An increase of serum 
      pH and bicarbonate was observed after PEs when FFP was used as replacement fluid 
      (Delta pH = +0.04 +/- 0.05; Delta bicarbonate = +3.6 +/- 3.68 mmol/L; Delta base excess = +1.62 +/- 
      4.51 mmol/L). The prophylactic administration of sodium bicarbonate corrected 
      partially the decrease of serum pH and bicarbonate after finishing PEs when 
      albumin was used as replacement fluid (Delta pH = -0.04 +/- 0.04; Delta bicarbonate = -3.1 
      +/- 2.47 mmol/L; Delta base excess = -3.35 +/- 3.06 mmol/L). The frequency of AEs after 
      using prophylactic administration of sodium bicarbonate was lower in comparison 
      with the frequency of AEs before using prophylactic administration of sodium 
      bicarbonate (2.0% vs. 4.8%; p < 0.001). CONCLUSION: A decrease of serum pH and 
      bicarbonate appeared in patients after PEs when albumin was used as replacement 
      fluid; it was corrected partially with prophylactic administration of sodium 
      bicarbonate, and it was associated with fewer AEs.
CI  - (c) 2015 AABB.
FAU - Cid, Joan
AU  - Cid J
AD  - Apheresis Unit, Department of Hemotherapy and Hemostasis, CDB, IDIBAPS, Hospital 
      Clinic, University de Barcelona, Barcelona, Spain.
FAU - Carbasse, Gloria
AU  - Carbasse G
AD  - Apheresis Unit, Department of Hemotherapy and Hemostasis, CDB, IDIBAPS, Hospital 
      Clinic, University de Barcelona, Barcelona, Spain.
FAU - Gamir, Montse
AU  - Gamir M
AD  - Apheresis Unit, Department of Hemotherapy and Hemostasis, CDB, IDIBAPS, Hospital 
      Clinic, University de Barcelona, Barcelona, Spain.
FAU - Jimenez, Maria
AU  - Jimenez M
AD  - Apheresis Unit, Department of Hemotherapy and Hemostasis, CDB, IDIBAPS, Hospital 
      Clinic, University de Barcelona, Barcelona, Spain.
FAU - Arellano-Rodrigo, Eduardo
AU  - Arellano-Rodrigo E
AD  - Apheresis Unit, Department of Hemotherapy and Hemostasis, CDB, IDIBAPS, Hospital 
      Clinic, University de Barcelona, Barcelona, Spain.
FAU - Lozano, Miguel
AU  - Lozano M
AD  - Apheresis Unit, Department of Hemotherapy and Hemostasis, CDB, IDIBAPS, Hospital 
      Clinic, University de Barcelona, Barcelona, Spain.
LA  - eng
PT  - Journal Article
DEP - 20150812
PL  - United States
TA  - Transfusion
JT  - Transfusion
JID - 0417360
RN  - 0 (Bicarbonates)
RN  - 2968PHW8QP (Citric Acid)
SB  - IM
MH  - Acid-Base Equilibrium
MH  - Bicarbonates/blood
MH  - Citric Acid/adverse effects
MH  - Female
MH  - Humans
MH  - Hydrogen-Ion Concentration
MH  - Male
MH  - Plasma Exchange/*adverse effects
MH  - Retrospective Studies
EDAT- 2015/08/13 06:00
MHDA- 2016/03/15 06:00
CRDT- 2015/08/13 06:00
PHST- 2015/02/27 00:00 [received]
PHST- 2015/05/21 00:00 [revised]
PHST- 2015/05/25 00:00 [accepted]
PHST- 2015/08/13 06:00 [entrez]
PHST- 2015/08/13 06:00 [pubmed]
PHST- 2016/03/15 06:00 [medline]
AID - 10.1111/trf.13215 [doi]
PST - ppublish
SO  - Transfusion. 2015 Nov;55(11):2653-8. doi: 10.1111/trf.13215. Epub 2015 Aug 12.