• P Le Conte, F Nicolas, C Adjou, J M N'Guyen, E Billaud, and P Moreau.
• Service de Réanimation Médicale, Centre Hôspitalier Universitaire, Nantes, France.
• Intensive Care Med. 1997 Mar 1;23(3):342-4.

ObjectiveTo compare the tolerance and the cost of three replacement fluids in plasmapheresis: albumin 4% alone, albumin 4% + dextran 40, or albumin 4% + hydroxyethylstarch 6%.DesignA one center randomized, cross-over, comparative study designed to explore the tolerance and the colloid oncotic pressure in patients undergoing plasmapheresis.Patients225 plasmapheresis procedures were performed in 27 patients.Measurements And ResultsHemodynamic tolerance was good in the three treatment groups. Serum protein concentration after plasmapheresis was significantly lower in the albumin + hydroxyethylstarch group, followed by albumin + dextran 40, versus albumin alone. Colloid oncotic pressure before and after exchange was similar in the three groups.ConclusionsThe clinical use of 25-30% of hydroxyethylstarch 6% or dextran 40 with albumin 4% was clinically well tolerated and associated with a 12% decrease of the cost of substitution solutions.

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