Analysis of the use and complications of peripheral vascular access in centrifuge-based therapeutic plasma exchange

Abstract

Introduction: Therapeutic plasma exchange is an extracorporeal blood purification technique. Centrifuge-based therapeutic plasma exchange (plasmacentrifugation) requires flows of 50 ml/min which allows the exchange with peripheral vascular accesses. The main objective of this study is to analyze the use and complications of peripheral vascular access in plasmacentrifugation sessions. Material and Method: Descriptive observational longitudinal study on the analysis of peripheral vascular access complications in plasmacentrifugtion sessions between January 2017 and March 2018. Results: A total of 93 plasmacentrifugation sessions were included. Sessions were carried out in 9 patients with a median of 7 [P25:6; P75:10.5] per patient. 66.66% (n=6) were women. Centrifugation was used in 89.24% (n=83) of the sessions and in 10.75% (n=10) photoaferesis. The etiologies of the disease for these patients were: renal in 55.55% (n=5) of cases, neurological in 33.33% (n=3) of cases and dermatological in 11.11% (n=1).There were problems related to the channeling of peripheral vascular access in 52.69% of the sessions (n= 49). Conclusions: Because in more than half of the sessions there were complications in the channeling of peripheral vascular access, it is concluded that ambulatory vascular study of the patient is necessary before the first session, the use of ultrasound guided puncture may be useful.