Therapeutic Plasma Exchange in the Critically Ill Patient: Technology and Indications

TPE should be considered an additional tool in the management of select patients in the ICU setting. It is important to be aware of the techniques of apheresis available, including centrifugal- and membrane-based systems, as well as the special considerations with each technique that must be made for the critically ill patient. The ASFA guidelines are an excellent resource to provide a quick reference for the indications for TPE, the level of evidence supporting that indication, and technical aspects of the prescription and performance of the procedure. There is increasing interest in the use of TPE or selective plasma processing for the management of severe and emerging global infections.