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

Ildiko Toth, Andras Mikor, Tamas Leiner, Zsolt Molnar, Lajos Bogar, Tamas Szakmany

Research output: Contribution to journalArticle

14 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)618-622
Number of pages5
JournalJournal of Anesthesia
Volume27
Issue number4
DOIs
Publication statusPublished - Aug 1 2013

Keywords

  • C-reactive protein
  • Immunoglobulin
  • Mortality
  • Organ failure
  • Procalcitonin
  • Respiratory failure
  • Septic shock

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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