Sepsis's archives

Present Data on Ig Effectiveness in Sepsis The available clinical trials do not yet allow definitive answers regarding the effectiveness of Ig treatment in human sepsis in general. Thus, its use remains controversial and will have to await the results of large placebo-controlled studies, one of which is currently underway. canadian neighbor pharmacy In selected subsets of patients with sepsis, however, there is growing evidence that prophylactic or therapeutic Ig administration may reduce disease severity’ and even mortality. These potential Ig effects have been classically attributed to the antitoxic and opsonic activity of the antibodies administered or their synergism with |3-lactam antibiotics. More recently, there is in vitro evidence for modulation of monokine production by Ig, such as down-regulation of interleukin 6 synthesis.

Continue reading " Comparison of Early IgM-Enriched Immunoglobulin vs Polyvalent IgG Administration in Score-Identified Postcardiac Surgical Patients at High Risk for Sepsis (Discussion) "

Study Population During the study period, 870 patients were eligible for postoperative score-based risk stratification. APACHE II scoring in this total population on the first postoperative day identified 29 (3.3%) high-risk patients (score: >24). Of these patients, 27 patients were treated within the study. Two patients (7%) had to be excluded, since Igs had been administered outside the randomization procedure on the basis of clinical judgment of the physician in charge. Of the 27 patients included, 13 had been randomized to receive IgGMA and 14 to receive IgG. No Ig treatment side effects were recorded. At study entry, systemic inflammatory response syndrome (SIRS) was present in all but one patient (96%). Mean Elebute sepsis scores were 12.4 (11.6 to 13.2) and thus in the range indicative […]

Continue reading " Comparison of Early IgM-Enriched Immunoglobulin vs Polyvalent IgG Administration in Score-Identified Postcardiac Surgical Patients at High Risk for Sepsis (Results) "

Study Population and Treatment Regimen From July 1992 to July 1993, in all patients undergoing elective open-heart surgery (excluding transplantation) at the Department of Cardiac Surgery, Grosshadem Hospital, University of Munich, APACHE II scores were prospectively assessed on the first postoperative day (“day 1”) using a microcomputer-based scoring program.16 Patients fulfilling the previously validated high-risk criterion of an APACHE II score >24 on day l8 were randomized to receive one of the following supplemental Ig regimens in an open manner: IV IgG (Polyglobin N; Tropon Biologische Praparate; Cologne, Germany; dosage, day 1: 12 mL/kg; day 2: 6 mL/kg) or IV IgGMA (Pentaglobin; Biotest; Dreieich, Germany; dosage, 5 mL/kg on days 1, 2, and 3). The study preparations were commercially purchased. There was no restriction regarding […]

Continue reading " Comparison of Early IgM-Enriched Immunoglobulin vs Polyvalent IgG Administration in Score-Identified Postcardiac Surgical Patients at High Risk for Sepsis (Materials and Methods) "

Study objective: To address the relevance of the IgM component in polyvalent immunoglobulins in sepsis treatment by comparison of the clinical course under polyvalent IgG vs IgGMA therapy in postcardiac surgical patients at high risk for sepsis and to reassess the prognostic validity of sequential changes in acute physiology and chronic health evaluation (APACHE II) scores during treatment. Design: Prospective, randomized clinical trial.Setting: Cardiac surgical ICU in a university hospital.Patients: Among 870 consecutive patients after elective open-heart surgery, 29 (3.3%) met the previously validated high-risk criterion (APACHE II score >=24 on the first postoperative day) with a mean APACHE II score-predicted mortality risk of 63%.

Continue reading " Comparison of Early IgM-Enriched Immunoglobulin vs Polyvalent IgG Administration in Score-Identified Postcardiac Surgical Patients at High Risk for Sepsis (Introduction) "