What cholesterol level would you expect after a one-volume therapeutic plasma exchange procedure using 5% albumin as the replacement fluid for a patient with an initial cholesterol of 210 mg/dL?

In a one-volume therapeutic plasma exchange, the patient's plasma volume is typically replaced with a replacement fluid, in this case, 5% albumin. The procedure effectively removes a significant portion of the patient's plasma, which contains cholesterol and other solutes.

When using 5% albumin as the replacement fluid, the replacement does not contain cholesterol. Therefore, it leads to a dilution effect of the existing cholesterol levels in the plasma.

Given that the initial cholesterol level is 210 mg/dL, the exchange removes about half of that cholesterol, bringing down the concentration in the remaining plasma. After the procedure, it’s expected that the cholesterol level would be significantly lower since the albumin used cannot replenish those cholesterol levels.

Calculating roughly, if you remove the patient's plasma containing cholesterol and replace it entirely with albumin, the remaining concentration would be approximately one-half of the initial level. Thus, a decrease down to around 80 mg/dL is a reasonable estimate.

This understanding of how plasma volume and solute concentration respond to therapeutic exchange helps clarify why 80 mg/dL is the anticipated outcome following this fluid replacement procedure.