Therapeutic apheresis in critically ill patients

• Published in: Journal of clinical apheresis Vol. 26; no. 5; pp. 249 - 251
• Main Authors: Sanford, Kimberly W., Balogun, Rasheed A.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 2011
• Subjects: Acute Lung Injury - therapy; Antibodies - isolation & purification; apheresis; Blood Component Removal - adverse effects; Blood Component Removal - methods; Critical Illness - therapy; critically ill; Humans; Pharmaceutical Preparations - isolation & purification; plasma exchange; Plasma Exchange - methods; plasmapheresis; Transfusion Reaction
• ISSN: 0733-2459; 1098-1101
• DOI: 10.1002/jca.20304

Therapeutic apheresis procedures in critically ill patients comprises of therapeutic plasma exchange in most cases but also less commonly, erythrocytapheresis (red cell exchange), thrombocytapheresis, or leukocytapheresis. These procedures present a number of challenges to the apheresis healthcare team, and there are myriad beneficial and adverse effects for patients. In this patient population, one has to weigh the risks against the benefits and especially in those situations where apheresis is requested as a treatment when other alternative therapies have failed. Therapeutic plasma exchange is capable of removing toxins, pathologic auto‐ and allo‐antibodies but will also remove beneficial medications, clotting factors and cations which are chelated by citrate anticoagulant. Herein, we review clinically significant issues that are commonly encountered in patients that are in the intensive care unit and have conditions that require therapeutic apheresis. J. Clin. Apheresis 2011. © 2011 Wiley‐Liss, Inc.