Plasmapheresis in the critically ill patient

Area of Science:

• Critical Care Medicine
• Hematology
• Nephrology

Background:

• Plasma exchange (PE) and plasmapheresis are established therapeutic apheresis techniques.
• These procedures are employed across a broad spectrum of diseases.
• Evidence supporting their efficacy is limited to a select number of conditions.

Purpose of the Study:

• To review and discuss established and potential indications for PE and plasmapheresis in critically ill patients.
• To evaluate the clinical effectiveness of these treatments based on available evidence.
• To outline the complications and potential side effects associated with PE and plasmapheresis.

Main Methods:

• Literature review of controlled clinical trials and observational studies.
• Analysis of evidence for established and emerging indications.
• Synthesis of data on safety and adverse events.

Main Results:

• Clinical effectiveness of PE and plasmapheresis is robustly supported by large trials in only a limited number of diseases.
• Numerous other conditions are treated with these techniques, but evidence is less conclusive.
• Complications and side effects are associated with these procedures and require careful monitoring.

Conclusions:

• While PE and plasmapheresis have a wide range of applications, their proven efficacy is restricted to specific clinical scenarios.
• Further research, including large controlled trials, is needed to establish the effectiveness of these treatments in many other conditions.
• Careful consideration of risks versus benefits is essential when employing PE and plasmapheresis in critically ill patients.