Irritated veins from IVIG?

    • bny806
      March 15, 2013 at 2:50 am

      Hello all! I hope everyone is doing ok.. I am almost 2 years into the whole IVIG thing and maintaining pretty well. We have been spreading out my IVIG to every 3 weeks.. though I think I probably need it every 2, but my veins are really irritated.. they are thinmking about adding immunosuppresants..   Anyhow does anyone else have this problem?? I have tenderness of the vein after infusion- all the way up my arm.. and my leg veins also get inflammed (DVT’s have been ruled out btw)..  I take NSAIDs to help, but just curious if anyone else has this reaction – I have been able to increase my rate as my body otherwise seems to have adapted to IVIG better in a lot of ways.. Thanks so much in advance!

    • Bill
      March 15, 2013 at 6:41 pm

      I had the same irritation in the beginning.  We were running fast and several times had to changer site because of vein irritation.  We now do IVIG at a maximum of 50 ml per hour and have no vein or site irritation.  You might try slowing down.

    • bny806
      March 20, 2013 at 3:10 pm

      Thanks so much!!! I will have them slow it down.. How much saline do you get after the infusion?? I used to get 150 I believe, but due to the infusion taking so long, we have cut it back to 50-75 in the past several infusions.. I wonder if that has anything to do with it?? They said I could cut it out completely, but I feel like it washing out my veins is a good thing!

    • Bill
      March 20, 2013 at 5:45 pm

      We don’t flush with saline as immune globulin “does not like saline” and calls for dextrose flush and we just flush with enough to clear the lines.

      go to http://www.health.gov.nl.ca/health/bloodservices/pdf/guidelines_for_administration_of_ivig.pdf
      Post Administration

      5.5.1

      Flush IV line with 5% dextrose in water (D5W) or co
      mpatible
      solution following the transfusion.

      5.5.2

      Disconnect the IVIG administration set.

      5.5.3

      Document post transfusion information on the compat
      ibility
      label/tag and recipient’s chart following completio
      n of the
      transfusion.

      5.5.4

      Return the laboratory portion of the compatibility
      label/tag to the
      Transfusion Laboratory according to policy.

      5.5.5

      Monitor the recipient for at least 30 minutes after
      the transfusion.

      5.5.6

      Dispose of IVIG product bottles or containers and t
      ubing in
      compliance with standard precautions according to h
      ospital policy
      and procedure.

    • bny806
      March 21, 2013 at 1:14 am

      Thanks Bill!   So, funny you mention that about the D5/saline issue.. I noticed at my infusion on monday that they just hooked the saline right up to my iv after my ivig.. I realized then that they hadn’t used D5 to flush the past several infusions.. I asked about it, and they said that just a few months back it came out that it was now ok/compatible to use saline with the gammunex and you dn’t have to flush with D5 in between.. I wasn’t sure if i should believe this or not, as I don’t have a ton of faith in the infusion people from past experience, so wasn’t sure if they were just telling me that due to htem forgetting- have you heard anything like that – that the compatability has now been disproven?

    • GH
      March 21, 2013 at 2:05 am

      Bill, I don’t see globulin “does not like saline” in that document, or any indication that IvIg is not compatible with normal saline. Whom are you quoting?

      Either dextrose (d-glucose) or normal saline is given intra venously because they are compatible with the blood. I don’t see how saline could be a problem since the blood is saline.

    • GH
      March 21, 2013 at 2:13 am

      Here is the data sheet on Gamunex-C. It is mixed with dextrose for dilution, but the line may be flushed with either dextrose or saline solution.

      http://www.talecris-pi.info/inserts/gamunex.pdf