Therapeutic plasma exchange in an intensive care unit (ICU): A 10-year, single-center experience

Plasma exchange in the intensive care unit: Technical aspects and complications

“…Nonetheless, only 5 (1.9%) episodes of significant gastrointestinal haemorrhage and 16 (6.8%) minor bleeding at the insertion site of the CVC were reported. Our results are in accordance with previous studies conducted in the ICU setting, where the incidence of significant bleeding episodes was consistently <5% of the procedures …”

“…To our knowledge, we report one of the largest studies with a prospective collection of the data, focused on ICU patients who had an indication of plasma exchange recommended by the American Society for Apheresis . Previous studies reported a rate of major adverse events during the procedure ranging from 0 to 2.8%, and a rate of minor adverse events ranging from 8.1 to 30.5% . Our experience was similar with a rate of life‐threatening complications of 1.1% and a rate of nonlife‐threatening complications of 26.9%, regardless the technique implemented (centrifugation or filtration).…”

“…6 Previous studies reported a rate of major adverse events during the procedure ranging from 0 to 2.8%, and a rate of minor adverse events ranging from 8.1 to 30.5%. [10][11][12][13] Our experience was similar with a rate of lifethreatening complications of 1.1% and a rate of nonlifethreatening complications of 26.9%, regardless the technique implemented (centrifugation or filtration). Hypotension was the most frequently reported, accounting for 8% of the procedures.…”

“…Although a substantial number of studies have documented the risks of plasma exchange procedure, [7][8][9] there is little information about the feasibility of the technique in the ICU setting. [10][11][12][13] Critically ill patients are more likely to experience hemodynamic instability, coagulation disorders or electrolyte disturbances that may hamper the efficacy of the technique. We prospectively studied all adult patients admitted to our ICU who required plasma exchange therapy.…”

First Experience and the Effectiveness of Immunomodulating Treatment in Inflammatory Demyelinating CNS Diseases: Analysis of Nine Patients / Imūnmodulējošās Terapijas Efektivitāte Centrālās Nervu Sistēmas Iekaisīgu Saslimšanu Gadījumos: Deviņu Pacientu Analīze

“…Basic TPE application is recommended at a rate of five times daily or every other day; exchanging 1-1.5 times total plasma volume per session, in patients with neurological disease (Yilmaz et al, 2011;Kes et al, 2012). Five plasma exchange sessions are usually prescribed and believed to be sufficient to achieve antibody removal.…”