title: Masking of the symptoms of esophageal and bowel perforation by combination treatment of sepsis with polyvalent immunoglobulins and low-dose hydrocortisone.
abstract: 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.
authors.affiliation: Department of Anesthesia, University of Heidelberg, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Böhrer
authors.forename: H
authors.initials: H
authors.lastname: Schmidt
authors.forename: A
authors.initials: A
authors.lastname: Bach
authors.forename: B W
authors.initials: BW
authors.lastname: Böttiger
authors.forename: J
authors.initials: J
authors.lastname: Motsch
mesh_terms: 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*
chemical_list: D000893:Anti-Inflammatory Agents; D007070:Immunoglobulin A; D007075:Immunoglobulin M; C060166:pentaglobulin; D006854:Hydrocortisone