Therapeutic Plasma Exchange
Posted: Wednesday, December 15th, 2021 | Updated: Sunday, January 15th, 2023
Posted: Wednesday, December 15th, 2021 | Updated: Sunday, January 15th, 2023
Therapeutic Plasma Exchange Example (This is only one example. Please ask the Doctor for their specific directions):
The Doctor requests that a 30 kg canine have 450 ml of blood (1 unit of whole blood) pulled via a central line and collected into a blood bag to later be spun down and separated into plasma and packed red blood cells. The blood bag we are using states clearly that it holds 450 ml of whole blood and has an predetermined amount of CPD anticoagulant and preservation solution in it. The Doctor requests that the patient's plasma be disposed of properly and that the patient's packed red blood cells be delivered back to them quickly with the addition of 100 ml 0.9% NaCl to help facilitate this. The Doctor then would like the patient to receive a double unit or about 250 ml of plasma over 4 hours instead of a crystalloid bolus to help replace the volume lost
The Basic Blood Collection Process via Jugular Catheter:
The Doctor requests that a 30 kg canine have 450 ml of blood (1 unit of whole blood) pulled via a central line and collected into a blood bag to later be spun down and separated into plasma and packed red blood cells. The blood bag we are using states clearly that it holds 450 ml of whole blood and has an predetermined amount of CPD anticoagulant and preservation solution in it. The Doctor requests that the patient's plasma be disposed of properly and that the patient's packed red blood cells be delivered back to them quickly with the addition of 100 ml 0.9% NaCl to help facilitate this. The Doctor then would like the patient to receive a double unit or about 250 ml of plasma over 4 hours instead of a crystalloid bolus to help replace the volume lost
The Basic Blood Collection Process via Jugular Catheter:
The Initial Materials and Collection of Patient Blood via Jugular Catheter:
The collection set below has one collection bag and two satellite bags. If you wanted to spilt the obtained plasma into two single units, you could use both bags. In our case, we'll only be using one of the satellite bags. When collecting the blood from the patient, if the collection bag is placed on the gram scale and zeroed out, 450 ml of blood will be approximately 477 grams. Remember, 1 ml of blood is roughly 1.06 grams
The collection set below has one collection bag and two satellite bags. If you wanted to spilt the obtained plasma into two single units, you could use both bags. In our case, we'll only be using one of the satellite bags. When collecting the blood from the patient, if the collection bag is placed on the gram scale and zeroed out, 450 ml of blood will be approximately 477 grams. Remember, 1 ml of blood is roughly 1.06 grams
Turn on The Centrifuge and Set to the Appropriate Settings:
With the centrifuge below, we are able to spin the whole blood down over about 6 minutes at roughly 5000 rpm. Our centrifuge is chilled when ready. We often will use an intravenous fluid bag as a counterweight. In this case, we are using a 500 ml bag of intravenous fluids
With the centrifuge below, we are able to spin the whole blood down over about 6 minutes at roughly 5000 rpm. Our centrifuge is chilled when ready. We often will use an intravenous fluid bag as a counterweight. In this case, we are using a 500 ml bag of intravenous fluids
Transferring the Plasma to the Satellite Bag:
Use the plasma press to assist the transfer of plasma into the satellite bag. You must break the seals located at the entrance of each bag to allow the plasma to flow out of the original bag and into the other. Break the seals by gently snapping the line with your hands. Only break the seals of which you need. Once you have transferred and discarded the plasma, give the red blood cells back to the patient promptly with the addition of 100 ml 0.9% NaCl to facilitate the process. Then administer a new thawed bag of plasma over 4 hours as directed by the Doctor in the example above. Always take care to administer blood products appropriately with proper documentation, drip rates, and vital signs to verify a patient is not having a transfusion reaction
Use the plasma press to assist the transfer of plasma into the satellite bag. You must break the seals located at the entrance of each bag to allow the plasma to flow out of the original bag and into the other. Break the seals by gently snapping the line with your hands. Only break the seals of which you need. Once you have transferred and discarded the plasma, give the red blood cells back to the patient promptly with the addition of 100 ml 0.9% NaCl to facilitate the process. Then administer a new thawed bag of plasma over 4 hours as directed by the Doctor in the example above. Always take care to administer blood products appropriately with proper documentation, drip rates, and vital signs to verify a patient is not having a transfusion reaction
Sources:
On The Job Training and Routine Practices
On The Job Training and Routine Practices