Fig. 3

SVPE procedure for patients with GBS. A loading dose of low-molecular weight heparin (1.5 mg/kg) will be given subcutaneously at least 2 hours before initiation of SVPE; the same dose will be administered once daily or divided into two equal doses daily for 8 days or until SVPE is completed. Whole blood (7 mL/kg body weight) will be drawn from the central venous catheter into the blood transfusion bag in each session. The blood bag will be hung beside the patient for 2.5 h on a saline stand and left uninterrupted to allow plasma and blood cells to separate. The blood cells will be infused back into the patient and plasma will be discarded and replaced with fresh frozen plasma and colloid solution alternately (in equal volumes) via the closed-circuit SVPE kit illustrated in Fig. 2. In case of excessive clotting (bleeding time reduction of > 50% of baseline for that patient), aspirin (600 mg) will be administered orally at least 2 hours before the next SVPE session and continued thereafter at 150 mg orally/day until SVPE is completed. One blood bag will be used each day, with a total of six sessions/day. A total of 48 sessions will be performed over 8 days, removing approximately 8000 mL plasma in total