Journal of Anesthesia

, Volume 27, Issue 4, pp 618–622

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
Short Communication

DOI: 10.1007/s00540-012-1553-9

Cite this article as:
Toth, I., Mikor, A., Leiner, T. et al. J Anesth (2013) 27: 618. doi:10.1007/s00540-012-1553-9

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.

Keywords

Septic shockImmunoglobulinProcalcitoninRespiratory failureMortalityOrgan failureC-reactive protein

Copyright information

© Japanese Society of Anesthesiologists 2013

Authors and Affiliations

  • Ildiko Toth
    • 1
  • Andras Mikor
    • 1
    • 2
  • Tamas Leiner
    • 1
  • Zsolt Molnar
    • 1
    • 2
  • Lajos Bogar
    • 1
  • Tamas Szakmany
    • 1
    • 3
    • 4
  1. 1.Department of Anaesthesiology and Intensive TherapyUniversity of PecsPecsHungary
  2. 2.Department of Anaesthesiology and Intensive TherapyAlbert Szent-Gyorgyi University of SzegedSzegedHungary
  3. 3.Department of Anaesthetics, Theatres and Critical CareCwm Taf LHBLlantrisantWales, UK
  4. 4.Department of Anaesthesia, Intensive Care and Pain Medicine, Medical SchoolCardiff UniversityCardiffWales, UK