Phillippe R. Bauer, Division of Pulmonary and Critical Care, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. Bauer.Philippe@mayo.edu
Marlies Ostermann, Department of Critical Care, King's College London, Guy's & St Thomas' Hospital, London, UK
Lene Russell, Department of Critical Care, King's College London, Guy's & St Thomas' Hospital, London, UK
Chiara Robba, Anesthesia and Intensive Care, Policlinico San Martino, Genoa, Italy
Sascha David, Institute of Intensive Care Medicine, University Hospital Zurich, Zurich, Switzerland
Bruno Ferreyro, Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada
Joan Cid, Unitat d'Afèresi i Teràpia Cel·lular, Banc de Progenitors Hematopoètics, Servei d'Hemoteràpia i Hemostàsia, ICMHO, Hospital Clinic, IDIBAPS, Barcelona, Spain
Pedro Castro, Medical Intensive Care Unit, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
Nicole P. Juffermans, Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam University Medical Center, Amsterdam, The Netherlands
Luca Montini, Department of Intensive Care Medicine and Anesthesiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy
Tasneem Pirani, Critical Care Unit, King's College Hospital NHS Foundation Trust, London, UK.
Andry Van De Louw, Penn State Health, Hershey, USA
Nathan Nielsen, Division of Pulmonary, Critical Care and Sleep Medicine, University of New Mexico School of Medicine, New Mexico, USA
Julia Wendon, Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK
Anne C. Brignier, Apheresis Unit, Immuno-Hematology, Hôpital Saint-Louis, APHP, Paris, France
Miet Schetz, Division of Cellular and Molecular Medicine, Clinical Department and Laboratory of Intensive Care Medicine, KU Leuven University, Leuven, Belgium
Jan T. Kielsetin, Nephrology | Rheumatology | Blood Purification, Academic Teaching Hospital Braunschweig, Brunswick, Germany
Jeffrey L. Winters, Division of Transfusion Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, USA
Elie Azoulay, Médecine Intensive et Réanimation, Hôpital Saint-Louis, APHP, Paris, France
Nine-I Investigators

Document Type

Article

Publication Date

10-2022

Abstract

In this narrative review, we discuss the relevant issues of therapeutic plasma exchange (TPE) in critically ill patients. For many conditions, the optimal indication, device type, frequency, duration, type of replacement fluid and criteria for stopping TPE are uncertain. TPE is a potentially lifesaving but also invasive procedure with risk of adverse events and complications and requires close monitoring by experienced teams. In the intensive care unit (ICU), the indications for TPE can be divided into (1) absolute, well-established, and evidence-based, for which TPE is recognized as first-line therapy, (2) relative, for which TPE is a recognized second-line treatment (alone or combined) and (3) rescue therapy, where TPE is used with a limited or theoretical evidence base. New indications are emerging and ongoing knowledge gaps, notably regarding the use of TPE during critical illness, support the establishment of a TPE registry dedicated to intensive care medicine.

Download

Share

COinS