[Serum IgG concentrations and antibody titer of burn patients after preventive intravenous IgG substitution with a Pseudomonas immunoglobulin].
In a randomized clinical trial 30 patients with burn injury received supportive therapy with a Pseudomonas hyperimmunoglobulin (Psomaglobin N). The control group received no additional therapy. The patients of both groups were between 15 and 60 years of age and had a full-thickness burn of 30-70% of the body surface area with inhalational trauma being optional. The whole trauma was classified and scored with the 'Abbreviated Burn Severity Index' (which allows another extra score point for inhalational trauma). Both groups underwent the same intensive care unit treatment with preference to early wound excision and wound grafting following functional aspects of reconstructive surgery. Bacteriological monitoring was performed on suspicion of wound infection and bacteremia by taking wound swabs and blood cultures. The supportive treatment group received a total of 250 mg/kg hyperimmunoglobulin on days 3, 5, 7, 10, and 13. Of 30 patients in the control group 16 had an additional inhalation trauma, and 8 of those (50%) died (only 1 of 14 patients without inhalation trauma died). In the group receiving supportive treatment, 23 out of 30 patients had an inhalation trauma, and 8 of those (35%) died (1 of 7 patients without inhalation trauma). In both groups with inhalation injury, the patients were at risk of developing bacteremia: 13 of 23 of the immunoglobulin-treated patients and 12 of 16 patients of the control group. Bacteremic controls died at a lower score than bacteremic immunoglobulin-treated patients (8.6 vs. 10.3 points).(ABSTRACT TRUNCATED AT 250 WORDS)
Abteilung für Anästhesiologie, Krankenhaus Merheim, Köln.
R
R
Stuttmann
M
M
Hartert
M
M
Jahn
G
G
Spilker
M
M
Doehn
D000293:Adolescent; D000328:Adult; D002056:Burns / Q000276:immunology / Q000628:therapy*; D002059:Burns, Inhalation / Q000276:immunology / Q000628:therapy; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis / Q000627:therapeutic use*; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000276:immunology / Q000628:therapy*; D011550:Pseudomonas aeruginosa / Q000276:immunology*; D018805:Sepsis / Q000276:immunology / Q000628:therapy*; D014946:Wound Infection / Q000276:immunology / Q000628:therapy*
D007074:Immunoglobulin G
IgG-Serum-Konzentrationen und Antikörpertiter brandverletzter Patienten nach prophylaktischer intravenöser IgG-Substitution mit einem Pseudomonas-Immunglobulin.