Clinical skills in therapeutic plasmapheresis in intensive care: A scoping review

Therapeutic plasmapheresis is a procedure primarily focused on modulating the immune system by removing specific antibodies and albumin-bound toxins implicated in the development of serious pathologies, and it is being used more frequently in intensive care units. In this therapeutic intervention, nursing teams mostly use the knowledge and skills acquired through experience with continuous dialysis techniques. However, the procedure is complex and advanced, requiring the development of specific skills.

To map the nursing interventions that facilitate the development of specific clinical skills for therapeutic plasmapheresis.

The methodology adopted was based on a scoping review. The Population, Concept, Context methodology was used to formulate the review question and to select the articles. The search was carried out in the scientific databases CINAHL, MEDLINE, COCHRANE, Virtual Health Library and international journals specializing in apheresis techniques knowledge, with the inclusion criteria "nursing care", "peer-reviewed articles" and the exclusion criteria "no full text" and "date less than 2017" applied. In addition, the most recent international guidelines on therapeutic plasmapheresis were included.

A total of 11 articles were identified, of which 7 are textual evidence articles, based on expert opinions and database searches, and 4 are quantitative studies; in addition to 5 guidelines related to the subject under analysis. These reflect the importance of developing skills in therapeutic plasmapheresis, categorized into general, technical, management and communication domains. Nursing interventions are based on the principle of clinical reasoning, promoting evidence-based practice. The relevance of certifying these skills through training is also highlighted, emphasizing the need for structured programs for an adequate approach to highly complex therapeutic interventions.

Therapeutic plasmapheresis plays an essential role in intensive care settings, covering various clinical scenarios, which requires an individualized approach and careful consideration of the person's specific clinical condition.