Population-Sri Lanka is an Island republic, with an area of 65, 610 sg. km, and an estimated population of 17.5 million. Type of Organization-The National Blood Transfusion Service (NBTS) is government managed, with a Director who functions under the Deputy Director General Laboratory Services, the Director General Health Services, the Secretary and the Minister of Health & Women's Affairs. Number of Blood Centres-The NBTS which was establised in 1962 with a Central Blood Bank (CBB) and one Regional Blood Bank (RBB), has now expanded to include 35 RBB and 12 Emergency Bleeding Centres (EBC). The CBB which has a staff of 117 functions as a routine Blood Centre for 3 large hospitals nearby, in addition to administration, logistics support and monitoring work performance of the RBB
We report on 41 patients with Guillain-Barré Syndrome (GBS) with disability grade 4 and 5 who were treated with manual plasma exchange (PE). Approximately 20-40 ml/kg body weight of plasma was removed with each manual PE; 63% of patients needed one PE, 24% needed two, 10% needed three, and 2% needed four plasma exchanges. Normal saline, human serum albumin (NSA) and fresh frozen plasma were used in varying proportions as replacement solutions. Ninety-one percent of the patients resumed walking with very little assistance ranging from 4 to 56 days with an average of 25 days from the commencement of the first PE. Manual PE in our series was effective and safe as the reported experience of automated apheresis and less volume of plasma was exchanged in our patients undergoing manual PE when compared to those treated in other studies employing automated PE.
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