Masking of the symptoms of esophageal and bowel perforation by combination treatment of sepsis with polyvalent immunoglobulins and low-dose hydrocortisone.
Sepsis is usually treated with surgical drainage, antibiotics, oxygenation optimization and volume resuscitation. Recent monoclonal and polyclonal anti-bodies have been used to treat sepsis by neutralizing the endotoxins and cytokines found in septic patients. This method does not significantly reduce mortality except in certain sub-populations of the treatment groups. We introduced a combination approach for sepsis treatment. This adjuvant therapy consists of polyclonal human immunoglobins together with infusion of low-dose hydrocortisone. This paper reports the results of this treatment in two different cases.
Böhrer
H
H
Department of Anesthesia, University of Heidelberg, Germany.
Schmidt
H
H
Bach
A
A
Böttiger
B W
BW
Motsch
J
J
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004939:Esophageal Perforation / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000627:therapeutic use*; D007070:Immunoglobulin A / Q000008:administration & dosage / Q000627:therapeutic use*; D007075:Immunoglobulin M / Q000008:administration & dosage / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D007416:Intestinal Perforation / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications / Q000628:therapy*
D000893:Anti-Inflammatory Agents; D007070:Immunoglobulin A; D007075:Immunoglobulin M; C060166:pentaglobulin; D006854:Hydrocortisone