Evaluation of fluid-related adverse events during therapeutic plasma exchange in Guillain-Barré syndrome

Sourav Das; Trishna Saha; Umma Asma Saki; Farhana Munmun; Anamul Haque; Jannatul Ferdause; Rifat Hasan; Mohammad Abdul Kadir

doi:10.18203/2320-6012.ijrms20261664

Authors

Sourav Das Department of Transfusion Medicine, National Centre for Control of Rheumatic Fever and Heart Diseases, Dhaka, Bangladesh
Trishna Saha Department of Transfusion Medicine, National Institute of Kidney Diseases and Urology, Sher-E-Bangla Nagar, Dhaka, Bangladesh
Umma Asma Saki Department of Medicine, Mugda Medical College Hospital, Dhaka, Bangladesh
Farhana Munmun Department of Transfusion Medicine, KPJ Specialized Hospital, Dhaka, Bangladesh
Anamul Haque Department of Transfusion Medicine, Green Life Hospital, Dhaka, Bangladesh
Jannatul Ferdause Department of Ophthalmology, Mugda Medical College Hospital, Dhaka, Bangladesh
Rifat Hasan Department of Transfusion Medicine, National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh
Mohammad Abdul Kadir Department of Medicine, Mugda Medical College Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2320-6012.ijrms20261664

Keywords:

Fluid-related adverse events, 5% albumin, Fresh frozen plasma, Therapeutic plasma exchange, Guillain-Barré syndrome

Abstract

Background: Therapeutic plasma exchange (TPE) is used to treat moderate to severe Guillain-Barré syndrome (GBS), but it can cause fluid-related adverse events influenced by the type of replacement fluid, such as FFP or 5% albumin. Objectives were to evaluate and compare the frequency and severity of fluid-related adverse events during TPE in GBS patients receiving FFP or 5% albumin.

Methods: This cross-sectional study was conducted at BSMMU and NINS, Dhaka, from October 2021 to September 2022. Eighteen confirmed GBS patients undergoing TPE were equally divided into fresh frozen plasma (FFP) (n=9) and 5% albumin (n=9) groups, and 90 sessions were analyzed. Fluid-related adverse events were recorded and analyzed using SPSS version 22, with p<0.05 considered significant.

Results: A total of 22 adverse events were recorded (24.4% of sessions). Hypocalcemia was the most frequent complication (7.8%), followed by hypotension (6.7%), fever (5.6%), and allergic reactions (4.4%). Adverse events were numerically higher in the FFP group compared to the albumin group: fever (8.9% vs 2.2%), allergic reactions (6.7% vs 2.2%), hypotension (11.1% vs 2.2%), and hypocalcemia (11.1% vs 4.4%), though differences were not statistically significant (p>0.05). Most events were mild (72.7%), and no severe complications were observed.

Conclusions: Both FFP and 5% albumin were generally safe during TPE in GBS patients, though FFP showed a higher frequency of immediate fluid-related adverse events. Larger multicenter studies are needed to confirm these findings.

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