A rare plasma exchange, which was performed at a city hospital on a 14-year-old boy who had consumed mosquito repellant, has been recently published in the Journal of Clinical Toxicology.

The 60-hour procedure, which involved the separation and removal of plasma from the blood to clean toxic substances from it, was performed at Sir Ganga Ram Hospital on the boy who was admitted to the hospital on November 1 last year after consuming the toxic fluid following a tiff with his parents.

According to doctors, Ankit Sharma’s (name changed) body colour changed after he consumed the mosquito repellant. He was then rushed to a private hospital in Delhi from where he was referred to Sir Ganga Ram Hospital.

The life-saving plasma exchange was performed at Sir Ganga Ram Hospital in the Capital

“He was in critical condition when we received him in the casualty ward. His haemoglobin was at dangerously low levels, his liver was affected with jaundice and kidneys were at the risk of failure. Oxygen supply to his vital organs was reducing,” director of paediatric emergency, critical care and pulmonology at the hospital Dr Anil Sachdev said while adding that the latest techniques were used to increase his urine output and salvage his kidneys.

According to Sachdev, the treatment procedure had to be changed as tests revealed that the patient suffered from G6PD deficiency. It was then decided to perform plasma exchange on the 14-year-old.

“The red blood cells, white blood cells and platelets were returned to the patient along with a prescribed replacement fluid,” Sachdev said.

After the 60-hour long procedure, Sharma’s condition improved and he was subsequently shifted to the normal ward. Six days later, he was discharged from the hospital. The procedure involves the removal of large-molecular-weight substances such as harmful antibodies from the plasma.

It is usually carried out using an automated blood cell separator to ensure fluid balance and maintain a normal plasma volume. This may require the insertion of a femoral or jugular line to allow adequate blood flow.

Typically, plasma are removed at each procedure and replaced with isotonic human albumin solution.