title: Effects of IgM-enriched immunoglobulin therapy in septic-shock-induced multiple organ failure: pilot study.
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.
authors: Department of Anaesthesiology and Intensive Therapy, University of Pecs, Pecs, Hungary.
authors: Ildiko
authors: I
authors: Toth
authors: Andras
authors: A
authors: Mikor
authors: Tamas
authors: T
authors: Leiner
authors: Zsolt
authors: Z
authors: Molnar
authors: Lajos
authors: L
authors: Bogar
authors: Tamas
authors: T
authors: Szakmany
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000188:drug therapy* / Q000209:etiology*; D010865:Pilot Projects; D011446:Prospective Studies; D012772:Shock, Septic / Q000150:complications* / Q000188:drug therapy*
chemical_list: D007075:Immunoglobulin M