VASCULAR ACCESS FOR THERAPEUTIC PLASMA-EXCHANGE

Adequate venous access is an essential component of therapeutic plasma exchange (TPEX). The simplest kind of venous access is venipuncture o f antecubital veins, but this technique may be limited by venous size or scarring following the procedure, requiring the placement of a spec ialized vascular access device (VAD). VADs provide reliable central ve nous access and may remain in place for several weeks or months, depen ding on the VAD and the venous site chosen. Their use, however, is pot entially limited by the risk of complications. We discuss indications for insertion, choice of catheter and access site, and complications o f VAD placement for TPEX.