Plasmapheresis can benefit a variety of critically ill patients. A woman with diabetic ketoacidosis and severe hypertriglyceridemia was treated with plasmapheresis when conventional treatments did not markedly reduce her triglyceridemia. The patient was admitted to a medical intensive care unit because of diabetic ketoacidosis with severe lipemia. The lipemia-associated interference in laboratory studies made treatment of electrolyte abnormalities extremely difficult. The hypertriglyceridemia was initially treated with insulin, antilipidemic medications, and heparin, but the levels of triglycerides remained elevated, delaying results of needed laboratory studies for hours. After plasmapheresis, the serum level of triglycerides decreased by 77% in less than 24 hours. Severe lipemia interferes with photometric laboratory studies, yielding an underestimation of serum levels of electrolytes. Plasmapheresis is safe, rapid, and effective for emergent management of severe hypertriglyceridemia in critically ill patients. The impact of the procedure on critical care nursing is growing as nurses become involved in the treatment and follow-up care of patients who have plasmapheresis.
Articles| August 01 2013
Plasmapheresis in the Management of Severe Hypertriglyceridemia
Gilbert Seda, MD, PhD;
Gilbert Seda is a commander in the Medical Corps, US Navy, Department of Pulmonary and Critical Care Medicine, Naval Medical Center San Diego, San Diego, California.
Corresponding author: Gilbert Seda, md, phd, Pulmonary Medicine, Ste 301, 34730 Bob Wilson Dr, San Diego, CA 92134 (e-mail: firstname.lastname@example.org).
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Jill M. Meyer, MD;
Dennis E. Amundson, DO;
Crit Care Nurse (2013) 33 (4): 18-23.
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Gilbert Seda, Jill M. Meyer, Dennis E. Amundson, Massoud Daheshia; Plasmapheresis in the Management of Severe Hypertriglyceridemia. Crit Care Nurse 1 August 2013; 33 (4): 18–23. doi: https://doi.org/10.4037/ccn2013346
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