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BRIEF COMMUNICATIONS: J. A. Grillo, K. C. Gorson, A. H. Ropper, J. Lewis, and R. Weinstein Rapid infusion of intravenous immune globulin in patients with neuromuscular disorders Neurology 2001; 57: 1699-1701 [Abstract] [Full text] [PDF]

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Rapid infusion of intravenous immune globulin in patients with neuromuscular disorders

Edward D Gomperts, Fred Darr   (1 March 2002)

Rapid infusion of intravenous immune globulin in patients with neuromuscular disorders 1 March 2002
Edward D Gomperts Baxter BioScience Baxter Healthcare Corporation Glendale CA, Fred Darr Send Correspondence to journal: Re: Rapid infusion of intravenous immune globulin in patients with neuromuscular disorders Sunny_Pearson{at}baxter.com Edward D Gomperts, et al.	Grillo et al. reviewed the use of rapid infusion of immune globulin intravenous in patients with neuromuscular disorders. [1] Their abstract and discussion claim safety and convenience of this practice in their population of patients and the final sentence of their abstract states "Rapid infusion IVIg can be given safely and conveniently in many patients with neuromuscular disorders." While this is accurate for the majority of their patients, the authors report 89 adverse events in 341 rapid infusions in 50 patients, 3.5% of which were considered "major." This amounted to a "major" event in 11 out of 50 patients (22%). It is these "major" events, and their frequency, which is of concern to us as these events, included chest pain, myocardial infarction, congestive cardiac failure, severe headache requiring hospitalization, pulmonary embolism and "transfusion related acute lung injury." These serious occurrences are certainly related directly to the rapid infusion protocol (reaching as high as 800 ml/hour) in what is essentially an at- risk population. Some of these adverse events are noted in the product information insert for the product used, and our own recent analysis of them reported via pharmacovigilance, has identified rapid infusion of immune globulin intravenous as a possible risk factor. It is strongly recommended that clinicians and other health care workers such as pharmacists and nurses who may be associated with the therapeutic administration of immune globulin intravenous, read and understand the product insert and follow the noted recommendations related to the rate of infusion of this therapeutic agent. Reference: 1) Grillo JA, Gorson K C, Ropper A H, Lewis J, Weinstein R. Rapid infusion of intravenous immune globulin in patients with neuromuscular diseases. Neurology 2001;57:1699.1701.