Exchange Transfusion in Severe Falciparum Malaria :
A Simple Method Modified from Hemodialysis Circuit
BUNLUSAK ACHAVANUNTAKUL,M.D.*, SOMCHAI EIAM-ONG, M.D.**,
TERAPONG TANTAWICHIEN,M.D.***, PEN PAN NUALBOONMA, M.D.****,
VIRA KASANTIKUL, M.D.****
Affiliation : * Nephrology Unit, Medicine, Ubon Ratchathani Province Hospital, Ubon Ratchathani 34000,
**Division of Nephrology,
*** Division of Infectious Disease, Department of Medicine,
**** Department of Pathology, Faculty of Medicine, Chulalongkom University, Bangkok 10330, Thailand.
AbstractWe set up a simple extracorporeal circuit, modified from the extracorporeal method
generally used in conventional hemodialysis, for exchange transfusion. Temporary vascular
access was used in exchange transfusion for both draining the infected blood and infusion of
the freshly non-infected blood. This method of exchange transfusion was performed in 3
severe complicated falciparum malaria patients who had a percentage of parasitemia of 80,
40, and 35. The magnitude of parasitemia decreased immediately to less than one per cent
and this value persisted twenty-four hours after the procedure. No complications of exchange
transfusion were detected in all patients. Erythrocyte morphology determined by scanning
electron microscopy was unaltered by exchange transfusion. Because of the simplicity, the
effectiveness, and the safety of the procedure, this extracorporeal circuit modified from
hemodialysis circuit would be a more beneficial exchange transfusion method in the treatment
of severe complicated falciparum malaria than the manually-performed one.
Keywords : Exchange Transfusion, Severe Falciparum Malaria, Hemodialysis, Erythrocyte Morphology
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