Giving IVIG

[Izzie77]

I was wondering if anyone could share your hospital's policy on giving IVIG. Do you do frequent vital signs? Do you need to use an in-line filter?

Thanks!

[IVTeam]

At our hospital IV IG is not filtered. It must be infused through a line with D5W. The IVIG dose is determined by the MD but we calculate the rate of the infusion. Vital signs are obtained pre-infusion. After the infusion is started, vitals are obtained every 15 minutes. If after the 15 minute increment if the vitals are stable then the infusion is titrated up for another 15 minutes. After the 2nd 15 mins vitals are obtained and if vitals are stable the infusion is again titrated aand this continues for 2 more cycles of 15 mins. The remaining drip is infused at the rate of the 4th increment and vitals are obtained 30mins and 1 hour after the infusion is completed. If the patient is going to experience an adverse reaction it usually occurs during the titration.

[mianders, RN]

We do not use a filter with IVIG. We start our infusions at 30ml/hr and titrate up every 15 minutes and vs are taken at the same rate. Our maximum infusion rate is 250ml/hr. I have some patient that do their dose over 2 days. 1/2 each day because their dose is so large.

[iluvivt, BSN, RN]

if it needs to be filtered pharmacy usually does it but you must follow manfact reccomendations...... yes you must take frequent vital signs...especially in the beginning with thr frequent rate increases..... the product is made from multiple pooled doners so the potential for a reaction is always present....oveall incidence of adverse reactions is approx 5% with a range of 1-15% non-immunodeficient pts have a rate of less than 1% remember most reactions are r/t the rate hypersensitivity reactions reactions secondary to previous sensitization usually occur 30-60 min after the start of the infusion hope this helps mary