Safety Profile of 5% Albumin Versus Fresh Frozen Plasma in Therapeutic Plasma Exchange for Guillain-Barré Syndrome

Open Access

Abstract

Background: Therapeutic plasma exchange (TPE) is an established treatment for Guillain-Barré syndrome (GBS). Although generally safe, mild complications may occur. Fresh frozen plasma (FFP) and 5% albumin are commonly used replacement fluids, and their comparative safety remains clinically important. Objective: To compare the safety profile of 5% albumin and fresh frozen plasma as replacement fluids during therapeutic plasma exchange in patients with Guillain-Barré syndrome. Methods & Materials: This comparative cross-sectional study was conducted at BSMMU and NINS, Dhaka, from October 2021 to September 2022. Eighteen GBS patients undergoing TPE were equally divided into FFP and 5% albumin groups. A total of 90 TPE sessions were analyzed for immediate complications, including fever, allergic reactions, hypotension, and symptomatic hypocalcemia. Data were analyzed using SPSS version 22, with p < 0.05 considered significant. Results: Baseline demographic and anthropometric characteristics were comparable between groups (p > 0.05). Fever occurred in 2.2% of albumin sessions versus 8.9% of FFP sessions. Allergic reactions were observed in 2.2% and 6.7%, hypotension in 2.2% and 11.1%, and symptomatic hypocalcemia in 4.4% and 11.1% of sessions in the albumin and FFP groups, respectively. Although complications were numerically higher in the FFP group, differences were not statistically significant (p > 0.05). Conclusion: Both replacement fluids were generally safe during TPE in GBS patients; however, 5% albumin showed relatively fewer immediate complications than fresh frozen plasma.