Journal Article

Intravenous Polyclonal Immunoglobulin Administration to Sepsis Syndrome Patients: A Prospective Study in a Pediatric Intensive Care Unit

Ahmed El-Nawawy, Hassan El-Kinany, Mona Hamdy El-Sayed and Nevine Boshra

in Journal of Tropical Pediatrics

Volume 51, issue 5, pages 271-278
Published in print October 2005 | ISSN: 0142-6338
Published online October 2005 | e-ISSN: 1465-3664 | DOI: http://dx.doi.org/10.1093/tropej/fmi011
Intravenous Polyclonal Immunoglobulin Administration to Sepsis Syndrome Patients: A Prospective Study in a Pediatric Intensive Care Unit

Show Summary Details

Preview

Life-threatening infections account for about 25 per cent of children requiring admission to pediatric intensive care units (PICU). The results of the use of polyclonal intravenous immunoglobulins as an adjuvant in pediatric sepsis syndrome therapy are conflicting. A prospective study of 100 sepsis syndrome PICU patients aged 1–24 months and divided into two matching groups (septic cases and control, 50 patients each) was performed. All patients were treated according to the routine protocol PICU therapy. Only the cases group received, in addition, polyclonal IVIG (Pentaglobin, Biotest) in a dose of 400 mg/kg for 3 days. All cases were evaluated for PRISM III score 8 h after admission; routine blood, urine, stool and cerebrospinal fluid (whenever appropriate) culture. Daily laboratory examination (blood gases, electrolytes, liver and renal functions, complete blood picture and C-reactive protein) were performed for the first 5 days. Blood samples were obtained for evaluation of tumor necrosis factor-alpha (TNF-α) daily for the first 5 days. Referral site (ward or casuality), length of PICU stay (LOS) and outcome (discharged or deceased), the number and percentage of cases who progressed to complications were recorded. Results showed that group I had a significantly higher percentage of discharged cases (72 per cent vs. 44 per cent), significantly shorter LOS (6.1 days vs. 9.1 days), and a significantly lower percentage of progress to complications (8 per cent vs. 32 per cent) especially disseminated intravascular coagulation (4 per cent vs. 24 per cent). TNF-α was significantly reduced among septic cases on discharge (2.24 vs. 3.6 mg/dl, p<0.001). A multiple logistic regression model revealed that treatment with IVIG, LOS, severity of sepsis and lymphocyte percentage (L per cent) on admission were significant predictors for survival. In summary the study revealed that the use of polyclonal IVIG among PICU sepsis syndrome showed a significant reduction in mortality, LOS and less progress to complications. A multicenter study is recommended to confirm these results.

Journal Article.  0 words. 

Subjects: Paediatrics

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.