Effect of therapeutic phlebotomy on plasma volume in polycythemia patients

• Main Authors: Mohandoss Murugesan, Soumya Das, Shamee Shastry
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2018-01-01
• Series: Global Journal of Transfusion Medicine
• Subjects: Phlebotomy; plasma volume; polycythemia
• Online Access: http://www.gjtmonline.com/article.asp?issn=2468-8398;year=2018;volume=3;issue=2;spage=117;epage=120;aulast=Murugesan
• ISSN: 2468-8398; 2455-8893

Background: Therapeutic phlebotomy (TP) helps in reducing the red cell mass thereby whole blood viscosity to improve tissue perfusion and oxygen delivery in polycythemia patients. We aimed to determine the plasma volume changes in polycythemia patients undergoing TP. Materials and Methods: We studied TP procedures in 134 patients undergoing 236 episodes prospectively. Patient clinical details were recorded to assess improvement in symptoms after the procedure. Plasma volume changes were calculated based on the difference between the pre- and postcollection blood volume. The influence of frequency of blood collected on plasma volume was analyzed. Results: A progressive reduction in hematocrit (1.7 ± 2.6 %) and hemoglobin (0.78 ± 0.5 g/dL) in relation to volume removed and frequency was observed . The mean blood removed during TP in these patients was 304 ± 58.1 mL. There was a progressive increase in plasma volume with respect to the frequency of TP (2.51 ± 1.58 mL/kg). Conclusion: Symptomatic improvements following TP were noted in 60% of patients. TP though commonly performed for reducing red cell mass in polycythemia had poor compliance from patients, resulting in failure to achieve desired levels.