CENTRAL AND PERIPHERAL HEMODYNAMIC PARAMETERS DURING AUTOPLASMA DONATION IN PREGNANT WOMEN

Objective. To evaluate the impact of autodonor plasmapheresis (PA) on the central and peripheral hemodynamics and blood oxygen-carrying function in pregnant women, by applying an integral computer monitoring system. Subjects and methods. A study group consisted of 212 pregnant women. Autoplasma was banked by intermittent plasmapheresis in an amount of 340-700 ml during 1-2 sessions at one-week interval at 32-37 weeks gestation, then stored, and transfused during surgery or labor. The central and peripheral hemodynamics and blood oxygen-carrying function during autodonor PA were assessed using an integral computer monitoring system that could use noninvasive procedures to record a wide range of indicators: heart rate; respiratory rate; systolic blood pressure (BP); mean BP; diastolic BP; stroke volume; cardiac output; arterial blood oxygen saturation; cardiac index (CI); stroke index; total peripheral vascular resistance; left ventricular work index; peripheral vascular resistance index; oxygen content in 100 ml of arterial blood (CaO2); oxygen delivery index. The patients were divided into 3 subgroups according to their CI: 1) 64 (30.2%) women with hyperkinetic circulation (5.0 L/min/m 2), 2) 106 (50%) women with eukinetic circulation (2.84 CI<5.0 L/min/m 2); 3) 42 (19.8%) with hypokinetic circulation (CI<2.8 L/min/m 2) Results. Analysis of the time course of changes in the parameters of central and peripheral hemodynamics and systemic oxygen transport showed that autoplasma donation had no significant impact on the status of pregnant women with hyperkinetic and eukinetic circulation. During PA, the pregnant women with hypokinetic circulation may show a short-term reduction in volumetric hemodynamic parameters; however, there is no blood oxygen-carrying dysfunction due to high hemoglobin levels. Doppler study provided support that autodonor PA had no negative effect on the fetus. Conclusion. The introduction of blood-saving techniques into obstetric/gynecological practice will be able to decrease the use of donor blood and its components, thus reducing the risk of different posthemotransfusion complications.

pregnancy, blood-saving technologies, autoplasma donation, plasmapheresis, central and peripheral hemodynamics, blood oxygen-carrying function, safety