PLASMAPHERESIS IN PREOPERATIVE MANAGEMENT OF PATIENT WITH THYROTOXICOSIS

The authors studied the efficacy of plasmapheresis in preoperative management of patients with thyrotoxicosis in intolerance of and resistance to thyrostatics. Seventy-three patients were examined. Preoperative management was accomplished by gravitation plasmapheresis (PP) with a PP-0.5 apparatus according to the continuous flow principle. The course consisted of 1-5 sessions during which a total volume of 800-5,000 ml of plasma was removed. Heparin was administered in a dose of 150-200 U/kg before PP. It was proved that the most rational technique was replacement of the lost plasma by reopolyglucin with albumin - 300 % of the total volume of the plasma substitute. Dynamic study of the level of the T3, T4, and TSH hormones proved that the use of such substituting medium leads to stable euthyroidism and that PP is the optimal method of preoperative management of patients with thyrotoxicosis in intolerance of and resistance to thyrostatics.