Plasmapheresis: technique and complications.

Plasmapheresis has been used in an increasing number of diverse conditions over the past 15 years, and patients on intensive care units are sometimes so treated. This article reviews the principles, different techniques and refinements available, including the more specific methods of antibody removal, such as immunoadsorption. The vascular access, anticoagulation, choice of fluid replacement and monitoring requirements are discussed. The reported possible complications of plasmapheresis, relating both to the practical aspects of the procedure and to the effects of plasma removal and the replacement fluids, are reviewed.