If it is not possible to place peripheral lines in a patient, what other catheterisation options would I have for administering Adacolumn®? What precautions do I have to consider?

Dr. Francisco Fernández

When we have patients where it is difficult to find adequate venous accesses, if we want to administer apheresis, we normally use central lines. Central lines channel larger calibre veins and it is usually necessary for the central catheter or vein cannula to have sufficient calibre to allow the afferent and efferent filtrate lines to be transported through the two lumens that are usually present in this type of device. If we have a conventional central line that has a smaller calibre, we can use the central line to return blood from the filter and use a peripheral line to collect blood and pass it through the filter. In such a way that the central line, if it is very long and of small calibre, if we were to use it as an afferent line, the negative pressure of the machine would probably lead to a collapse and emit alarm signals that would make it difficult to carry out the procedure normally.

• M. Golsorkhi, A.Azarfar,A.Abdipour Vascular access in therapeutic apheresis: One size does not fit all Ther Apher Dial  2022 26(4):694-716.