Optimisation de l’utilisation des dérivés du sang

This presentation, part of a congress on primary immunodeficiencies, focuses on practical modalities for administering immunoglobulins. The speaker, Professor Albibi, an immunologist, outlines the key decisions and actors involved: physician, nurse, patient, and manufacturer. He reviews the history, composition, and mechanisms of action of immunoglobulin products, emphasizing the importance of checking product characteristics such as concentration, osmolarity, and stabilizers. He details the pre-administration checklist, including clinical evaluation, baseline tests, and preparation. The infusion process is described with a stepwise increase in rate, with close monitoring for adverse reactions. Management of adverse reactions is stratified by severity, from slowing the rate to stopping and administering adrenaline. Contraindications and precautions are discussed, including IgA deficiency and renal/cardiac risks. The presentation compares intravenous and subcutaneous routes, highlighting their advantages and disadvantages. Key messages include starting slowly to prevent most reactions, using actual weight for dosing, screening for IgA deficiency, not mixing products, and documenting every step. The Q&A addresses the need for IgA screening in hematology patients before first administration.