ALBUMIN VERSUS FRESH FROZEN PLASMA IN MANAGING DIURETIC RESISTANT EDEMA IN CHILDREN WITH IDIOPATHIC NEPHROTIC SYNDROME

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Vishwajeet Singh ◽  
P K Berwal ◽  
T C Saini ◽  
Narender Mishra
Keyword(s):  
Nephrotic Syndrome ◽  
Pediatric Patients ◽  
Idiopathic Nephrotic Syndrome ◽  
Dry Weight ◽  
Fresh Frozen Plasma ◽  
Fresh Frozen ◽  
Double Number ◽  
Group A ◽  
Group B ◽  
Frozen Plasma

Background: This study was carried out to compare the efficacy and outcome of albumin with fresh frozen plasma (FFP) in the treatment of diuretic resistant edema in nephrotic syndrome Methods: Sixty patients with idiopathic NS were enrolled in this prospective analytic study. Patients with moderate to severe edema with serum albumin <1.5 gm/dl were given albumin and FFP dividing into two groups. Group-A, received intravenous albumin- 1 gm/kg/day and Group-B intravenous FFP 15ml/kg/day. Total number of albumin and FFP infusion were determined by edema reduction. Results: Diagnosis of NS and biochemical parameters were same in both groups. Dry weight was achieved in Group-A in 6.62± 3.15 days and in Group-B 6.65 ± 3.18 days. In GroupA the number of albumin infusion required was 1.42±0.62 and Group-B FFP infusion required was 3.11± 1.05 (p=0.0001). No significant complications were observed in both the groups. Conclusion: FFP cost half than albumin and same duration required to reduce edema but with double number of infusion and it is safe in pediatric patients with NS presenting with moderate to severe edema. Keywords: NS, Oedema, FFP, Albumin

scholarly journals Correction of Postoperative Anemia in Patients undergoing Mitral Valve Replacement through Blood Saving Technology

2020 ◽  
pp. 55-60
Author(s):  
B. M. Gumeniuk
Keyword(s):  
Blood Transfusion ◽  
Blood Cells ◽  
Fold Increase ◽  
Fresh Frozen Plasma ◽  
Packed Red Blood Cells ◽  
Fresh Frozen ◽  
Group A ◽  
Group B ◽  
Donated Blood ◽  
Frozen Plasma

The aim. To investigate anemia of chronic disease (ACD) in patients with mitral valvular disease, to provide preoperative correction in these patients and to determine the level of postoperative anemia after mitral valve replacement (MVR) through blood saving technology (BST) under artificial circulation (AC).Materials and methods. This is a study of 104 patients operated due to acquired mitral heart defects under AC. According to the baseline Hb, Ht, serum iron (SI) as well as the use of BST during MVR, all the patients were divided into 3 groups. Group A included 47 patients with normal Hb concentration, Ht and SI, who underwent the surgical intervention without BST with blood transfusion. Group B included 35 patients without ACD who were operated without blood transfusion with the use of BST. The group C included 22 patients with preoperative ACD with low Hb, Ht, and SI. A week before surgery the patients of group C underwent preoperative correction of SI and erythropoiesis stimulation using erythropoietin. The patients of group C were operated using BST. Preoperative correction of anemia and the use of blood and BST during surgery in groups A, B, C were compared. The effect of preoperative ACD correction and erythropoiesis stimulation on the level of postoperative anemia in patients operated due to mitral heart disease through BST in group C and with or without correction in group B was studied.Results. The presented research results show that in group A, in order to sufficiently stabilize the level of Hb and Ht during the operation, donated blood components (590.0 ± 83.0 ml of packed red blood cells and 563.0 ± 68.0 ml of fresh frozen plasma) were used. The use of BST in the group B reduced the level of Hb by 17.4%, Ht by 15.8%, thrombocyties by 20.5%, and the intervention could be performed without donated blood transfusion. Preoperative correction of SI and administration of erythropoietin in patients with ACD resulted in 8.6-fold increase in SI, 5.5-fold increase in ferritin and increase in Hb by 8.1% before the intervention. The use of BST and hematopoietic technology during MVR in patients of group C stabilized SI, Hb and platelets in the operative period, which facilitates operations under AC without transfusion of donated blood components.Conclusions.1. In patients of group A, donor blood components (590.0 ± 83.0 ml of packed red blood cells and 563.0 ± 68.0 ml of fresh frozen plasma) were used to stabilize Hb and Ht during MVR without the use of BST.2. ACD correction in patients of group C with mitral heart disease has led to a 8.6-fold increase in SI (p˂0.05), increase in transferrin saturation coefficient by 36.8% (p˂0.05), and 5.5-fold increase in ferritin activity (p˂0.05).3. The use of BST in patients of group B undergoing MVR reduces the level of Hb by 17.4% (* p˂0.05) and platelets by 20.5% (* p˂0.05).4. Preoperative correction of SI with iron (III) hydroxide and hemapoiesis stimulation by erythropoietin in patients of group C with MVR using BST reduces anemia by 10.7% and thrombocytopenia by 5%.

Neutrophil Elastase, Thrombin and Plasmin in Septic Shock: Influence on Prognosis

1987 ◽  
Author(s):  
R Seitz ◽  
M Wolf ◽  
R Egbring ◽  
K Havemann
Keyword(s):  
Septic Shock ◽  
Neutrophil Elastase ◽  
Antithrombin Iii ◽  
Active Form ◽  
Coagulation Factors ◽  
Fresh Frozen Plasma ◽  
Human Neutrophil Elastase ◽  
Fresh Frozen ◽  
Group A ◽  
Group B

The prognosis of septicaemia depends on the occurrence of disseminated disturbances of the microcirculation impairing organ function and haemorrhagic complications due to consumption of coagulation factors. The intravasal appearance of three potentially involved proteinases in active form can be detected by immunologic determination of their complexes with inhibitors: thrombin-antithrombin III (TAT), according to PELZER et al. (Thrombos. Haemostas. 54:24,1985); plasmin- antiplasmin (PAP), ldlE, antiserum donated by KARGES; human neutrophil elastase (HNE)- antitrypsin, ELISA, Merck, DarmstadtIn 47 patients with septic shock (19 survived, group A; 28 lethal, group B) the PAP levels were moderately elevated throughout the course without vaviations related to the outcome. TAT was initially strongly increased in both groups (18.8±6.3 ng/ml/16.5±7.2), and decreased towards the end of the course in both groups (2.7±0.5/3.7±0.8). Though the intial HNE levels were higher in group A (2458±348ng/ml) than in group B (1291±295, p=0.017), they decreased, in group A more rapidly and were at the end almost significantly lower than in group B (315±54/652&3x00B1;161, p=0,059). The decrease of TAT as well as HNE was associated with substitution of antithrombin III concentate (ATIII) and fresh frozen plasma (ffp) given with the aim of normalization of haemostasis and replacement of inhibitors. Factor XIII, a substrate of both thrombin and HNE, was initially equally low about 50% of normal in both groups, but increased only in group A (69.1±7.1/49.6±5.5, p=0.045) towards the end.Conclusions: Both TAT and HNE decreased after initial elevation under substitution of ATIII and ffp. A rapid decrease seems to be a favourable sign which is accompanied by rising levels of F XIII, while sustained elevation of HNE points to a poor prognosis

506: BLEEDING IN PEDIATRIC PATIENTS WITH PROLONGED INR: EFFECTS OF VITAMIN K AND FRESH FROZEN PLASMA

2020 ◽  
Vol 48 (1) ◽  
pp. 234-234
Author(s):  
Christine Koshel ◽  
Amanda Hassinger ◽  
Kelly Michienzi ◽  
Bree Kramer
Keyword(s):  
Vitamin K ◽  
Pediatric Patients ◽  
Fresh Frozen Plasma ◽  
Fresh Frozen ◽  
Frozen Plasma

Anesthesia for Pediatric Heart Transplantation: Are Patients With a Failing Hemi-Fontan- or Fontan-Physiology Different?

2019 ◽  
Vol 23 (4) ◽  
pp. 393-398 ◽  
Author(s):  
Matthias F. Mueller ◽  
Ann-Catrin Paul ◽  
Valesco Mann ◽  
Christian M. Koerner ◽  
Klaus Valeske ◽  
...  
Keyword(s):  
Coagulation Factor ◽  
Absolute Number ◽  
Fresh Frozen Plasma ◽  
Fontan Circulation ◽  
Bleeding Complications ◽  
Number Of Patients ◽  
Fresh Frozen ◽  
Inotropic Score ◽  
Group A ◽  
Group B

Background. The absolute number of patients presenting with failure of the hemi-Fontan or Fontan circulation for cardiac transplantation (cTx) will continuously rise. We aimed to analyze the intraoperative differences in patients undergoing cTx for a failing hemi-Fontan or Fontan circulation (group A) with those undergoing cTx for cardiomyopathy and congenital heart disease (group B). Methods. Data of patients undergoing cTx during a 10-year period were compared between group A and group B patients. Results. cTx was performed in 83 patients (group A, n = 21; group B, n = 62). Surgical times including median incision-suture time (549 minutes vs 386 minutes, P < .05) and median organ ischemia time (305 minutes vs 233 minutes, P < .05) were longer in group A patients. After weaning off cardiopulmonary bypass a higher median modified Vasoactive Inotropic Score (16 vs 10, P < .05) was necessary in group A patients. During surgery more fresh frozen plasma (44 mL/kg vs 20 mL/kg, P < .05), platelet concentrates (20 mL/kg vs 14 mL/kg, P < .05), and coagulation factor concentrates were given in group A patients. Mortality during the first 90 days after cTx was higher in group A (23.8% vs 6.5%, P < .05). Conclusion. Patients undergoing cTx for a failing hemi-Fontan or Fontan circulation are challenging. They require an intensive vasoactive and inotropic support; furthermore, special attention should be paid to the management of bleeding complications. cTx for this group of patients is associated with higher 90 days mortality.

scholarly journals Impact of Urinary Tract Infection on Steroid Response in Idiopathic Nephrotic Syndrome in Children

2014 ◽  
Vol 13 (2) ◽  
pp. 1-3
Author(s):  
Tanuka Barua ◽  
Razia Sultana ◽  
Pradip Kumar Datta ◽  
Jhulan Das Sharma ◽  
Md Rezaul Karim ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Nephrotic Syndrome ◽  
Urinary Tract ◽  
Tract Infection ◽  
Idiopathic Nephrotic Syndrome ◽  
Female Ratio ◽  
Steroid Response ◽  
Group A ◽  
Group B ◽  
The Impact

Context: UTI is one of the most common infection in nephrotic syndrome and may be a cause of delayed steroid response. Objective:To observe the impact of urinary tract infection on steroid response in idiopathic nephrotic syndrome children aged 2-6 years.Study design: Quasi experimental study Study period & place: Pediatric ward of Chittagong Medical College Hospital, Chittagong from 01.01.2009 to 31.12.2009. Participants: 52 Nephrotic syndrome children aged 2-6 years with typical clinical features Group A: Nephrotic syndrome with UTI, Group B: Nephrotic syndrome without UTI. Methods: Heat coagulation test, urine for R/M/E and C/S was done in every patient. Steroid was given according to standard regimen. Date of starting of steroid was recorded. Antibiotic was given in group A cases according to C/S report. Patients were followed for clinical and urinary remission. Group A and B were compared for remission time achieved by statistical method.Results: A male preponderance was noted about 57.7% against female about 42.3%. Generalized swelling of body & scanty micturation found in cent percent study group. Ascitis was found in 23.08%. Scrotal/labial swelling 7.69%.UTI developed in 30.8% of patients of NS. Male female ratio is 1:1. Infection delayed the remission of proteinuria. Mean remission time of NS without UTI patients was 7.39 days and with UTI patients was 9.31 days. In statistical analysis, mean remission time in group A =9.31+2.24 days(mean + SD), in group B=7.39+2.51 days(mean + SD), P value = <0.05, statistically significant.Conclusion: UTI in nephrotic syndrome causes delayed remission of proteinuria and may be asymptomatic.It should be screened in every nephrotic syndrome children routinely.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21046

scholarly journals Comparison of the Coagulation Effect Achieved by OctaplasLG Versus Fresh Frozen Plasma in Pediatric Cardiac Surgical Patients

2018 ◽  
Vol 24 (8) ◽  
pp. 1327-1332 ◽  
Author(s):  
Amanpreet S. Kalsi ◽  
Omar Al-Azzawi ◽  
Ravi Gill
Keyword(s):  
Cardiac Surgery ◽  
Disease Transmission ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Laboratory Data ◽  
Coagulation Factor ◽  
Fresh Frozen Plasma ◽  
Clotting Factors ◽  
Fresh Frozen ◽  
Frozen Plasma

OctaplasLG is indicated for use in patients undergoing cardiac surgery who require replacement of multiple clotting factors. The use of OctaplasLG over single-donor fresh frozen plasma (FFP) may have beneficial effects when considering the transmission of enveloped viruses. Additionally, it has the potential for fewer adverse reactions, reduced disease transmission, and a more homogenous coagulation factor composition. However, its efficacy and safety have not yet been evaluated in the pediatric population. Pediatric patients aged less than 2 years old and less than 10 kg, who underwent complete tetralogy of Fallot repair and received either OctaplasLG or FFP intraoperatively were identified over a 10-year period for this retrospective analysis. A review of case notes, intra-operative, and laboratory data were used to assess intraoperative blood product usage, blood loss, and postoperative coagulopathy. Data were analyzed to assess the efficacy of OctaplasLG in achieving hemostasis when compared to FFP. Results showed clinically better hemostasis postoperatively in OctaplasLG group compared with FFP group and better coagulation results. OctaplasLG was as effective as FFP when used in pediatric patients undergoing cardiac surgery.

Das Smith-Lemli-Opitz-Syndrom

2005 ◽  
Vol 5 (04) ◽  
pp. 178-182
Author(s):  
Wieland Kiess ◽  
Manuela Schulz ◽  
Sabine Liebermann ◽  
Roland Pfäffle ◽  
Peter Bührdel ◽  
...  
Keyword(s):  
Fresh Frozen Plasma ◽  
Therapeutische Möglichkeiten ◽  
Fresh Frozen ◽  
Frozen Plasma

ZusammenfassungDas Smith-Lemli-Opitz-Syndrom wird durch einen Defekt des letzten Schrittes der Cholesterolbiosynthese, den Mangel an 7-Dehydrocholesterolreduktase, verursacht. Die Akkumulation der Metaboliten 7-Dehydrocholesterol und 8-Dehydrocholesterol, die die wichtigsten biochemischen Marker für die Diagnose der Erkrankung darstellen, sowie der Mangel an Cholesterol können zu multiplen kongenitalen Anomalien führen. Die Ursache des Enzymmangels sind Mutationen innerhalb des DHCR7-Gens, welches auf Chromosom 11q13 lokalisiert ist. Therapeutische Möglichkeiten bestehen in der Gabe von Cholesterol und im Notfall Fresh Frozen Plasma (FFP); der therapeutische Nutzen von Statinen befindet sich zurzeit in der klinischen Erprobung.

The Recovery of Factor VIII from Fresh-Frozen, Indated and Outdated Human Plasma

1976 ◽  
Vol 36 (01) ◽  
pp. 071-077 ◽  
Author(s):  
Daniel E. Whitman ◽  
Mary Ellen Switzer ◽  
Patrick A. McKee
Keyword(s):  
Factor Viii ◽  
Polyacrylamide Gel Electrophoresis ◽  
Sodium Dodecyl ◽  
The United States ◽  
Fresh Frozen Plasma ◽  
Red Cross ◽  
Random Samples ◽  
Fresh Frozen ◽  
Factor Viii Concentrates ◽  
Frozen Plasma

SummaryThe availability of factor VIII concentrates is frequently a limitation in the management of classical hemophilia. Such concentrates are prepared from fresh or fresh-frozen plasma. A significant volume of plasma in the United States becomes “indated”, i. e., in contact with red blood cells for 24 hours at 4°, and is therefore not used to prepare factor VIII concentrates. To evaluate this possible resource, partially purified factor VIII was prepared from random samples of fresh-frozen, indated and outdated plasma. The yield of factor VIII protein and procoagulant activity from indated plasma was about the same as that from fresh-frozen plasma. The yield from outdated plasma was substantially less. After further purification, factor VIII from the three sources gave a single subunit band when reduced and analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis. These results indicate that the approximately 287,000 liters of indated plasma processed annually by the American National Red Cross (ANRC) could be used to prepare factor VIII concentrates of good quality. This resource alone could quadruple the supply of factor VIII available for therapy.

Haemophilia in a Female

1971 ◽  
Vol 26 (02) ◽  
pp. 205-210
Author(s):  
J. A McBride ◽  
J Hunter ◽  
Elizabeth Pearse ◽  
Yvette Sultan ◽  
J. P Caen
Keyword(s):  
Fresh Frozen Plasma ◽  
Plasma Fibrinogen ◽  
Fresh Frozen ◽  
Frozen Plasma

SummaryA case of haemophilia in a female is described together with the response of the patient’s level of antihaemophilic factor in the plasma following transfusion of fresh frozen plasma, fibrinogen and cryoprecipitate.

Severe Inherited “Homozygous” Protein C Deficiency in a Newborn Infant

1984 ◽  
Vol 52 (01) ◽  
pp. 053-056 ◽  
Author(s):  
A Estellés ◽  
I Garcia-Plaza ◽  
A Dasí ◽  
J Aznar ◽  
M Duart ◽  
...  
Keyword(s):  
Newborn Infant ◽  
Protein C ◽  
Skin Lesions ◽  
Fresh Frozen Plasma ◽  
Clinical Syndrome ◽  
Assay Method ◽  
Enzyme Linked Immunosorbent Assay ◽  
Protein C Deficiency ◽  
Fresh Frozen ◽  
Frozen Plasma

SummaryA relapsing clinical syndrome of skin lesions and disseminated intravascular coagulation (DIC) that showed remission with the infusion of fresh frozen plasma is described in a newborn infant with homozygous deficiency of protein C antigen.This patient presented since birth a recurrent clinical picture of DIC and ecchymotic skin lesions that resembled typical ecchymosis except for the fact that they showed immediate improvement with the administration of fresh frozen plasma. Using an enzyme linked immunosorbent assay method, the determination of protein C antigen levels in the patient, without ingestion of coumarin drugs, showed very low values (<1%).No other deficiencies in the vitamin-K-dependent factors or in anti thrombin III, antiplasmin, and plasminogen were found. Seven relatives of the infant had heterozygous deficiency in protein C antigen (values between 40-55%), without clinical history of venous thrombosis. The pedigree analysis of this family suggests an autosomal recessive pattern of inheritance for the clinical phenotype, although an autosomal dominant pattern has been postulated until now in other reported families.We conclude that our patient has a homozygous deficiency in protein C and this homozygous state may be compatible with survival beyond the neonatal period.

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