Abstract
While there is increasing knowledge on the mechanisms of biological efficacy of intravenous immunoglobulins(IVIG), their clinical effectiveness in septic patients remains a matter of controversy. At present, data suggest potential beneficial effects regarding a reduction in morbidity after IVIG prophylaxis or early treatment in selected patients. However, no large-sized controlled clinical trial has yet been able to document a significant reduction in mortality by IVIG treatment for the total population of adult septic patients.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Pollack M (1983) Antibody activity against Pseudomonas aeruginosa in immune globulins prepared for intravenous use in humans. J Infect Dis 147:1090–1098
Fischer GW, Hunter KW, Hemming VG et al (1983) Functional antibacterial activity of a human intravenous immunoglobulin preparation: In vitro and in vivo studies. Vox Sang 44: 296–299
Dalhoff A (1985) In vitro and in vivo effect of immunoglobulin G on the integrity of bacterial membranes. Infection 13[Suppl 2]:S185–S191
Andersson JP, Andersson UG (1990) Human intravenous immunoglobulin modulates monokine production in vitro. Immunology 71:372–376
Horiuchi A, Abe Y, Miyake M et al (1993) Natural human IgG inhibits the production of tumor necrosis factor and interleukin-1 alpha through the Fc portion. Surgery Today 23: 241–245
Skansen-Saphir U, Andersson J, Bjork L et al (1994) Lymphokine production induced by streptococcal pyrogenic exotoxin-A is selectively down-regulated by pooled human IgG. Eur J Immunol 24:916–922
Shimozato T, Iwata M, Tamura N (1990) Suppression of tumor necrosis factor alpha production by a human immunoglobulin preparation for intravenous use. Infect Immun 58: 1384–1390
Amran D, Renz H, Lack G et al (1994) Suppression of cytokine-dependent human T-cell proliferation by intravenous immunoglobulin. Clin Immunol Immunpathol 73:180–186
Svenson M, Hansen MB, Bendtzen K (1993) Binding of cytokines to pharmaceutically prepared human immunoglobulin. J Clin Invest 92:2533–2539
Pilz G, Fateh-Moghadam S, Vieil B et al (1993) Supplemental immunoglobulin therapy in sepsis and septic shock — comparison of mortality under treatment with polyvalent i.v. immunoglobulin versus placebo. Protocol of a multicenter, randomized, prospective, double-blind trial. Theor Surg 8:61–83
The Intravenous Immunoglobulin Collaborative Study Group (1992) Prophylactic intravenous administration of standard immune globulin as compared with core-lipopolysaccharide immune globulin in patients at high risk of postsurgical infection. N Engl J Med 327:234–240
Werdan K, Pilz G, and the SBITS Study Group (1997) Polyvalent immune globulins. Shock 7 [Suppl 1]:5
Dominioni L, Dionigi R, Zanello M et al (1991) Effects of high-dose IgG on survival of surgical patients with sepsis scores of 20 or greater. Arch Surg 126:236–240
Schedel I, Dreikhausen U, Nentwig B et al (1991) Treatment of Gram-negative septic shock with an immunoglobulin preparation: a prospective, randomized clinical trial. Crit Care Med 19:1104–1113
Werdan K, Pilz G (1992) Treatment of Gram-negative septic shock with an immunoglobulin. Letter to the Editor. Crit Care Med 20:1364–1365
Wortel CH, Dellinger P (1993) Treatment of Gram-negative septic shock with an immunoglobulin preparation: a prospective, randomized clinical trial. Letter to the Editor. Crit Care Med 21:163–165
Cafiero F, Gipponi M, Bonalumi U et al (1992) Prophylaxis of infection with intravenous immunoglobulins plus antibiotic for patients at risk for sepsis undergoing surgery for colorectal cancer: Results of a randomized, multicenter clinical trial. Surgery 112:24–31
Pilz G, Kreuzer E, Kaab S et al (1994) Early sepsis treatment with immunoglobulins after cardiac surgery in score-identified high-risk patients. Chest 105:76–82(Errata in 105:1924)
Kuhn C, Muller-Werdan U, Pilz G et al (1997) Early risk stratification of patients after cardiac surgery using extracorporeal circulation — identification of an escalating systemic inflammatory response syndrome. Eur Heart J 18[Suppl]:585
Petros AJ, Marshall JC, van Saene HKF (1995) Should morbidity replace mortality as an end-point for clinical trials in intensive care? Lancet 345:369–371
Knaus WA, Wagner DP, Zimmerman JE et al (1993) Variations in mortality and length of stay in intensive care units. Ann Intern Med 118:753–761
Knaus WA, Draper EA, Wagner DP et al (1985) APACHE II: A severity of disease classification system. Crit Care Med 13:818–829
Pilz G, Appel R, Kreuzer E et al (1997) Comparison of early IgM-enriched immunoglobulin vs polyvalent IgG administration in score-identified postcardiac surgical patients at high risk for sepsis. Chest 111:419–426
Mohr M, Englisch L, Roth A et al (1997) Effects of early treatment with immunoglobulin on critical illness polyneuropathy following multiple organ failure and gram-negative sepsis. Intensive Care Med 23:1144–1149
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1999 Springer-Verlag Italia, Milano
About this paper
Cite this paper
Pilz, G. (1999). Intravenous Immunoglobulins: Are They Helpful?. In: Baue, A.E., Berlot, G., Gullo, A., Vincent, JL. (eds) Sepsis and Organ Dysfunction. Springer, Milano. https://doi.org/10.1007/978-88-470-2248-5_16
Download citation
DOI: https://doi.org/10.1007/978-88-470-2248-5_16
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-0052-0
Online ISBN: 978-88-470-2248-5
eBook Packages: Springer Book Archive