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Effects of IgM-enriched immunoglobulin therapy in septic-shock-induced multiple organ failure: Pilot study

Toth, Ildiko, Mikor, Andras, Leiner, Tamas, Molnar, Zsolt, Bogar, Lajos and Szakmany, Tamas 2013. Effects of IgM-enriched immunoglobulin therapy in septic-shock-induced multiple organ failure: Pilot study. Journal of Anesthesia 27 (4) , pp. 618-622. 10.1007/s00540-012-1553-9

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Abstract

Mortality due to septic-shock–induced respiratory failure remains high. A recent meta-analysis suggested that IgM-enriched immunoglobulin treatment may be beneficial in these patients. In this prospective randomised controlled pilot study we investigated the effects of IgM-enriched immunoglobulin treatment in patients with early septic shock accompanied by severe respiratory failure. 33 patients were randomly allocated to receive 5 ml/kg (predicted body weight) IgM-enriched immunoglobulin (16 patients) or placebo (17 patients), respectively, via 8 h IV-infusion for three consecutive days. Daily Multiple Organ Dysfunction Scores (MODS) were calculated. Serum C-reactive protein (CRP) and procalcitonin (PCT) levels were monitored daily. For statistical analysis two-way ANOVA was used. Daily MODS showed ongoing multiple system organ failure without significant resolution during the 8 days. Median length of ICU stay, mechanical ventilation, vasopressor support during the ICU stay and 28-day mortality were nearly identical in the two groups. Serum PCT levels showed no significant difference between the two groups, however, CRP levels were significantly lower in the IgM-enriched immunoglobulin group on days 4, 5 and 6, respectively. In this study the use of IgM-enriched immunoglobulin preparation failed to produce any improvement in the organ dysfunction as compared to standard sepsis therapy.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: Q Science > QR Microbiology > QR180 Immunology
R Medicine > RC Internal medicine
R Medicine > RM Therapeutics. Pharmacology
Uncontrolled Keywords: Septic shock; Immunoglobulin; Procalcitonin; Respiratory failure; Mortality; Organ failure; C-reactive protein
Publisher: Springer
ISSN: 1438-8359
Last Modified: 30 Jun 2017 03:29
URI: http://orca.cf.ac.uk/id/eprint/58968

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