Rapid Plasma Exchange with the Continuous Flow Centrifuge

Four cases are described in which rapid exchange of large volumes of plasma (3.8–7.1 liters) was performed with the continuous flow centrifuge and unmodified fresh frozen plasma. Emphasis of this report is on the procedures used and the laboratory evaluation of the effects of plasma exchange. The patients received from 1,000 to 4,900 units of heparin and 628 to 1,299 ml of ACD during the procedure but no hemorrhagic complications were encountered. Supplementary calcium was administered to two patients and no clinical complications caused by hypocalcemia were observed. Serum potassium, chloride and bicarbonate were slightly decreased following plasma exchange, and hypernatremia did not occur. With careful evaluation and monitoring of patients, rapid plasma exchange with the continuous flow centrifuge appears to be practical and safe for the patient. 1973 AABB