- patients with plasma viscosity > 3.5 cp - moribund patients that the icu clinical team expects to die within 24 hrs - patients with any condition that, in the opinion of the clinical team or investigator, could increase the subject's risk by participating in the study or confound the outcome of the study - patients participating in another clinical trial that prohibits the use of tpe - pregnant women - prisoners

- patients with plasma viscosity > 3.5 cp - moribund patients that the icu clinical team expects to die within 24 hrs - patients with any condition that, in the opinion of the clinical team or investigator, could increase the subject's risk by participating in the study or confound the outcome of the study - patients participating in another clinical trial that prohibits the use of tpe - pregnant women - prisoners