Therapeutic Apheresis in Pediatrics with Neurological and Hematological Diseases

The advantages of therapeutic apheresis (TA) with hollow fiber membranes are a complete separation of the corpuscular components from the plasma and due to increased blood flow rate higher efficacy [1]. The use of therapeutic apheresis in pediatric patients, which increasing more and more, has always been restricted by technical difficulties and the low incidence of diseases requiring this kind of treatment. The development of new, more sophisticated membranes and new adsorption technologies allow the most selective separation of plasma components. TA has been successfully introduced in a variety of autoantibody-mediated diseases [2]. The updated information on immunology and molecular biology of different neurological and hematological diseases are discussed in relation to the rationale for apheresis therapy and its place in combination with other modern treatments. The different diseases can be treated by various apheresis methods. Pathogenetical aspects are demonstrated in these diseases, in which they are clarified. TA has been shown to effectively remove the autoantibodies from blood and lead to rapid clinical improvement. For the neurological and hematological diseases, which can be treated with TA, the guidelines of the Apheresis Application Committee (AAC) of the American Society for Apheresis (ASFA) are cited [3, 4].

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Therapeutic Apheresis in Neurology

Journal of Clinical Research and Reports ◽

10.31579/2690-1919/118 ◽

2020 ◽

Vol 5 (5) ◽

pp. 01-09

Author(s):

Rolf Bambauer

Keyword(s):

Neurological Disorders ◽

Neurological Diseases ◽

Blood Flow Rate ◽

Complete Separation ◽

Second Line Therapy ◽

Line Therapy ◽

The World ◽

American Society ◽

Increased Blood Flow ◽

Apheresis Therapy

Therapeutic plasma exchange (TPE) remove harmful plasma constituents from patient’s blood and replacing the extracted plasma with replacement solutions. The advantages of TPE with hollow fiber membranes are a complete separation of the corpuscular components from the plasma and due to increased blood flow rate higher efficacy. Therapeutic apheresis (TA) is used more and more throughout the world. The development of new, more sophisticated membranes and new adsorption technologies allow the most selective separation of plasma components. TA has been successfully introduced in a variety of autoantibody-mediated diseases. TA is the first- or second-line therapy in the treatment of neurological disorders. The updated information on immunology and molecular biology of different neurological diseases are discussed in relation to the rationale for apheresis therapy and its place in combination with other modern treatments. The different neurological diseases can be treated by various apheresis methods. Pathogenetical aspects are demonstrated in these diseases, in which they are clarified. TA has been shown to effectively remove the autoantibodies, immune complexes, inflammatory moderators, paraproteins, and other toxins from blood and lead to rapid clinical improvement. For the neurological diseases, which can be treated with TA, the guidelines of the Apheresis Application Committee (AAC) of the American Society for Apheresis (ASFA) are cited.

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Comparison of two interventions of increased blood flow rate and high-flux filters on hemodialysis adequacy and complications; a quasi-experimental study

Journal of Renal Injury Prevention ◽

10.15171/jrip.2017.47 ◽

2017 ◽

Vol 6 (4) ◽

pp. 247-252 ◽

Cited By ~ 1

Author(s):

Hosien Shahdadi ◽

Abbas Balouchi ◽

Maryam Jahantigh Haghighi

Keyword(s):

Experimental Study ◽

Blood Flow ◽

Flow Rate ◽

Blood Flow Rate ◽

High Flux ◽

Quasi Experimental ◽

Increased Blood Flow

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Prostacyclin production with serotonin, increased flow, or elevated venous pressure in dog lung

Journal of Applied Physiology ◽

10.1152/jappl.1990.69.4.1283 ◽

1990 ◽

Vol 69 (4) ◽

pp. 1283-1289 ◽

Cited By ~ 6

Author(s):

H. A. el-Kashef ◽

W. F. Hofman ◽

I. C. Ehrhart

Keyword(s):

Blood Flow ◽

Infusion Rate ◽

Venous Pressure ◽

Left Lung ◽

Blood Flow Rate ◽

Mechanical Stimuli ◽

Lung Lobe ◽

Normal Blood Flow ◽

Pulmonary Arterial ◽

Increased Blood Flow

The lung may release prostacyclin (PGI2) in response to humoral or mechanical stimuli. We measured 6 keto-PGF1 alpha as an index of PGI2 production during serotonin (5-HT) infusion, elevated venous pressure (Pv), or increased blood flow (Q) in the isolated canine lower left lung lobe (LLL). Lobar vascular resistance (LVR) was partitioned into arterial (Ra), middle (Rm), and venous (Rv) components by arterial and venous occlusions. The infusion of 55-210 micrograms/min 5-HT (n = 9) was associated with concomitant increases in PGI2 production and dose-related increases in pulmonary arterial pressure (Pa) and LVR. 5-HT increased Ra at each infusion rate, whereas Rm was not changed and Rv was increased only at the highest infusion rate. When Pa was increased by stepwise elevations in Pv from 3.7 to 19.1 cmH2O (n = 8) or by increases in Q from 250 to 507 ml/min (n = 5) to match the Pa increase observed during 5-HT infusion, PGI2 production was not altered. Increases in Pv reduced LVR largely by decreasing Ra, whereas increases in Q reduced LVR without changing Ra, Rm, or Rv. Infusion of 5-HT when Pa was held constant by reduction in blood flow (n = 6) did not increase PGI2. Thus infusion of 5-HT at a normal blood flow rate increased PGI2 formation in the isolated blood-perfused dog lung lobe. The results also suggest that sustained mechanical effects related to increased venous pressure or elevated blood flow are not associated with a sustained elevation of PGI2 formation.

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Reversed connection of cuffed, tunneled, dual-lumen catheters with increased blood flow rate maintains the adequacy of delivered dialysis despite the higher access recirculation

International Urology and Nephrology ◽

10.1007/s11255-019-02268-1 ◽

2019 ◽

Vol 51 (10) ◽

pp. 1841-1847

Author(s):

Varvara Kousoula ◽

Panagiotis I. Georgianos ◽

Konstantinos Mavromatidis ◽

Christos Syrganis ◽

Elias Thodis ◽

...

Keyword(s):

Blood Flow ◽

Flow Rate ◽

Blood Flow Rate ◽

Increased Blood Flow

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Improvement of PaO2 During One-Lung Ventilation With Partial Left-Heart Bypass in Pediatric Patients Is Caused by Increased Blood Flow to the Dependent Lung

Journal of Cardiothoracic and Vascular Anesthesia ◽

10.1053/j.jvca.2011.12.011 ◽

2013 ◽

Vol 27 (3) ◽

pp. 542-545 ◽

Cited By ~ 1

Author(s):

Koichi Yuki ◽

Kelly Chilson ◽

James A. DiNardo

Keyword(s):

Blood Flow ◽

Pediatric Patients ◽

Lung Ventilation ◽

Left Heart ◽

Dependent Lung ◽

One Lung Ventilation ◽

Left Heart Bypass ◽

Increased Blood Flow ◽

Heart Bypass

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Effect of Increased Blood Flow Rate on Hemodialysis Tolerability and Achieved Urea Reduction Ratio

Therapeutic Apheresis and Dialysis ◽

10.1111/1744-9987.12680 ◽

2018 ◽

Vol 22 (5) ◽

pp. 494-502 ◽

Cited By ~ 1

Author(s):

Peter Ryan ◽

Lauren Le Mesurier ◽

Kelly Adams ◽

Peter Choi ◽

Bobby Chacko

Keyword(s):

Blood Flow ◽

Flow Rate ◽

Blood Flow Rate ◽

Reduction Ratio ◽

Increased Blood Flow ◽

Urea Reduction Ratio

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Mathematical analysis of the relationship between blood flow and uptake of nutrients in the mammary glands of a lactating cow

Journal of Dairy Research ◽

10.1017/s0022029900031113 ◽

1995 ◽

Vol 62 (3) ◽

pp. 405-422 ◽

Cited By ~ 34

Author(s):

John P. Cant ◽

Brian W. McBride

Keyword(s):

Blood Flow ◽

Blood Flow Rate ◽

Mammary Glands ◽

Atp Production ◽

Flow Through ◽

Precapillary Sphincter ◽

Image Position ◽

The Relationship ◽

Increased Blood Flow ◽

Uptake Of Nutrients

SummaryA dynamic mathematical model of blood flow regulation in the mammary glands of a lactating cow was constructed from a principle of local vasodilator release in response to changes in intracellular adenylate charge. An equation was derived to predict uptake of the milk precursors acetate, glucose, amino acids and fatty acids, as affected by mammary blood flow rate. Metabolism of the precursors to milk components and CO2 was simulated with a set of empirically derived equations. Relative rates of ATP production and utilization regulated both the number of perfused capillaries and the conductance of arteriolar segments in the mammary glands. The model simulated local control phenomena of functional and reactive hyperaemia, and simulation of autoregulation under changing arterial pressure suggested a predominance of precapillary sphincter regulation. It was predicted that an increase in blood flow without the mammary capacity to utilize blood metabolites efficiently would be detrimental to milk synthesis. Conversely, increased blood flow through changes in mammary activity resulted in predictions of higher milk production. It was proposed that the equation for uptake,be used in analysis of mammary arteriovenous differences.

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Diastolic pressure and peripheral resistance during stellate ganglion stimulation

American Journal of Physiology-Legacy Content ◽

10.1152/ajplegacy.1963.204.1.71 ◽

1963 ◽

Vol 204 (1) ◽

pp. 71-72 ◽

Cited By ~ 1

Author(s):

Edward D. Freis ◽

Jay N. Cohn ◽

Thomas E. Liptak ◽

Aristide G. B. Kovach

Keyword(s):

Heart Rate ◽

Blood Flow ◽

Cardiac Output ◽

Total Peripheral Resistance ◽

Diastolic Pressure ◽

Stellate Ganglion ◽

Peripheral Resistance ◽

Resistance Vessels ◽

Left Stellate Ganglion ◽

Increased Blood Flow

The mechanism of the diastolic pressure elevation occurring during left stellate ganglion stimulation was investigated. The cardiac output rose considerably, the heart rate remained essentially unchanged, and the total peripheral resistance fell moderately. The diastolic rise appeared to be due to increased blood flow rather than to any active changes in resistance vessels.

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