{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T11:44:49Z","timestamp":1769687089029,"version":"3.49.0"},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2007,8,24]],"date-time":"2007-08-24T00:00:00Z","timestamp":1187913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2007,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>While therapeutic plasma exchanges (TPEs) performed with 5% albumin are considered safe, concerns regarding venous access and hypocalcemic toxicity remain. We reviewed the frequency of complications during TPEs performed with 5% albumin supplemented with calcium gluconate and potassium chloride for a 5 year period in our institution. Eighty\u2010four adult patients (46 males and 38 females) underwent 581 plasma exchanges during the study period. The most common indications were myasthenia gravis (37%), acute inflammatory demyelinating polyradiculoneuropathy (31%), and chronic inflammatory demyelinating polyneuropathy (13%). All procedures used 2.2% ACD\u2010A delivered at a calculated average rate of 0.26 mg\/kg\/min, which led to a mean dose of citrate per TPE of 2.18 \u00b1 0.48 g or 27.8 \u00b1 5.24 mg\/kg of body weight. Venous access difficulties occurred in 85 procedures (14.6%), but most TPEs were completed successfully. Hypotension and citrate toxicity were seen in &lt;5% of the TPEs and were mostly reversible. Only 17 exchanges (3%) had to be aborted because of the loss of venous access (<jats:italic>n<\/jats:italic> = 9), hypocalcemic toxicity (<jats:italic>n<\/jats:italic> = 3), hypotension (<jats:italic>n<\/jats:italic> = 2), panic attacks (<jats:italic>n<\/jats:italic> = 2), and one atypical reaction due to the interaction with an angiotensin converting enzyme inhibitor. Comparison between pre\u2010 and post\u2010TPE potassium levels showed a statistically significant mean decrease of 7%, from 4.1 mequiv\/l to 3.8 mequiv\/l (<jats:italic>P<\/jats:italic> &lt; 0.0001). We attribute the low rate of hypocalcemia to our practice of adding calcium and potassium to the replacement fluid and suggest that this method could become standard of care. J. Clin. Apheresis, 2007. \u00a9 2007 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/jca.20142","type":"journal-article","created":{"date-parts":[[2007,8,25]],"date-time":"2007-08-25T01:19:56Z","timestamp":1188004796000},"page":"265-269","source":"Crossref","is-referenced-by-count":36,"title":["Continuous infusion of calcium gluconate in 5% albumin is safe and prevents most hypocalcemic reactions during therapeutic plasma exchange"],"prefix":"10.1002","volume":"22","author":[{"given":"Suthida","family":"Kankirawatana","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu T.","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marisa B.","family":"Marques","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2007,8,24]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1098-1101(2000)15:1\/2<1::AID-JCA1>3.0.CO;2-R"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/jca.20134"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/jca.20129"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108083250604"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/jca.10041"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198403223101206"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0046-8177(83)80023-9"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1999.39399219285.x"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1994.341095026976.x"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1590\/S0004-282X2004000300003"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/jca.2920010306"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/jca.10000"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(12)80135-1"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1098-1101(1996)11:4<204::AID-JCA5>3.0.CO;2-F"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1986.26286152904.x"},{"key":"e_1_2_1_17_2","first-page":"881","article-title":"Changes in calcium distribution during therapeutic plasmapheresis","volume":"108","author":"Roberts WH","year":"1984","journal-title":"Arch Pathol Lab Med"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/jca.1022"}],"container-title":["Journal of Clinical Apheresis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjca.20142","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.20142","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T08:55:32Z","timestamp":1700038532000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jca.20142"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,8,24]]},"references-count":17,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2007,10]]}},"alternative-id":["10.1002\/jca.20142"],"URL":"https:\/\/doi.org\/10.1002\/jca.20142","archive":["Portico"],"relation":{},"ISSN":["0733-2459","1098-1101"],"issn-type":[{"value":"0733-2459","type":"print"},{"value":"1098-1101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,8,24]]}}}