Effect of Intravenous Immunoglobulin on the Outcome of Children with Septic Shock in a PICU: a Retrospective Cohort Study

Overview

Journal Eur J Pediatr

Specialty Pediatrics

Date 2023 Sep 21

PMID 37733114

Authors

Haixin Huang

Jian Chen

Hongxing Dang

Chengjun Liu

Junming Huo

Yue-Qiang Fu

Affiliations

Soon will be listed here.

Abstract

Conclusion: In children with septic shock, the use of intravenous immunoglobulin as an adjuvant therapy does not reduce in-hospital mortality.

What Is Known: • Guidelines suggest against the routine use of intravenous immuneglobulin in children with septic shock. Some small observational studies have reported conflicting result.

What Is New: • The use of intravenous immunoglobulin as an adjuvant therapy does not reduce in-hospital mortality in children with septic shock.

Citing Articles

A single-centre study on abnormal antinuclear antibodies in children caused by intravenous infusion of gamma globulin.

Xu L, Zhou J, Zhang Y, Wang Y, Yan X, Wang L Front Immunol. 2024; 15:1410661.

PMID: 39091491 PMC: 11291197. DOI: 10.3389/fimmu.2024.1410661.

References

Venet F, Rimmele T, Monneret G . Management of Sepsis-Induced Immunosuppression. Crit Care Clin. 2017; 34(1):97-106. DOI: 10.1016/j.ccc.2017.08.007. View

Shankar-Hari M, Spencer J, Sewell W, Rowan K, Singer M . Bench-to-bedside review: Immunoglobulin therapy for sepsis - biological plausibility from a critical care perspective. Crit Care. 2012; 16(2):206. PMC: 3584720. DOI: 10.1186/cc10597. View

Randhawa P, Pastrana D, Zeng G, Huang Y, Shapiro R, Sood P . Commercially available immunoglobulins contain virus neutralizing antibodies against all major genotypes of polyomavirus BK. Am J Transplant. 2015; 15(4):1014-20. PMC: 8320700. DOI: 10.1111/ajt.13083. View

Chaigne B, Mouthon L . Mechanisms of action of intravenous immunoglobulin. Transfus Apher Sci. 2017; 56(1):45-49. DOI: 10.1016/j.transci.2016.12.017. View

Toth I, Mikor A, Leiner T, Molnar Z, Bogar L, Szakmany T . Effects of IgM-enriched immunoglobulin therapy in septic-shock-induced multiple organ failure: pilot study. J Anesth. 2013; 27(4):618-22. DOI: 10.1007/s00540-012-1553-9. View

Iizuka Y, Sanui M, Sasabuchi Y, Lefor A, Hayakawa M, Saito S . Low-dose immunoglobulin G is not associated with mortality in patients with sepsis and septic shock. Crit Care. 2017; 21(1):181. PMC: 5508630. DOI: 10.1186/s13054-017-1764-4. View

El-Nawawy A, El-Kinany H, Hamdy El-Sayed M, Boshra N . Intravenous polyclonal immunoglobulin administration to sepsis syndrome patients: a prospective study in a pediatric intensive care unit. J Trop Pediatr. 2005; 51(5):271-8. DOI: 10.1093/tropej/fmi011. View

Goldstein B, Giroir B, Randolph A . International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med. 2005; 6(1):2-8. DOI: 10.1097/01.PCC.0000149131.72248.E6. View

Weiss S, Peters M, Alhazzani W, Agus M, Flori H, Inwald D . Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children. Pediatr Crit Care Med. 2020; 21(2):e52-e106. DOI: 10.1097/PCC.0000000000002198. View

10.

Straney L, Clements A, Parslow R, Pearson G, Shann F, Alexander J . Paediatric index of mortality 3: an updated model for predicting mortality in pediatric intensive care*. Pediatr Crit Care Med. 2013; 14(7):673-81. DOI: 10.1097/PCC.0b013e31829760cf. View

11.

Weisman L, Stoll B, Kueser T, Rubio T, Frank C, Heiman H . Intravenous immune globulin therapy for early-onset sepsis in premature neonates. J Pediatr. 1992; 121(3):434-43. DOI: 10.1016/s0022-3476(05)81802-5. View

12.

Darenberg J, Ihendyane N, Sjolin J, Aufwerber E, Haidl S, Follin P . Intravenous immunoglobulin G therapy in streptococcal toxic shock syndrome: a European randomized, double-blind, placebo-controlled trial. Clin Infect Dis. 2003; 37(3):333-40. DOI: 10.1086/376630. View

13.

Burns E, Lee V, Rubinstein A . Treatment of septic thrombocytopenia with immune globulin. J Clin Immunol. 1991; 11(6):363-8. DOI: 10.1007/BF00918802. View

14.

Hentrich M, Fehnle K, Ostermann H, Kienast J, Cornely O, Salat C . IgMA-enriched immunoglobulin in neutropenic patients with sepsis syndrome and septic shock: a randomized, controlled, multiple-center trial. Crit Care Med. 2006; 34(5):1319-25. DOI: 10.1097/01.CCM.0000215452.84291.C6. View

15.

Rodriguez A, Rello J, Neira J, Maskin B, Ceraso D, Vasta L . Effects of high-dose of intravenous immunoglobulin and antibiotics on survival for severe sepsis undergoing surgery. Shock. 2005; 23(4):298-304. DOI: 10.1097/01.shk.0000157302.69125.f8. View

16.

Pildal J, Gotzsche P . Polyclonal immunoglobulin for treatment of bacterial sepsis: a systematic review. Clin Infect Dis. 2004; 39(1):38-46. DOI: 10.1086/421089. View

17.

Parks T, Wilson C, Curtis N, Norrby-Teglund A, Sriskandan S . Polyspecific Intravenous Immunoglobulin in Clindamycin-treated Patients With Streptococcal Toxic Shock Syndrome: A Systematic Review and Meta-analysis. Clin Infect Dis. 2018; 67(9):1434-1436. PMC: 6186853. DOI: 10.1093/cid/ciy401. View

18.

Lee A, Chua A, Sultana R, Lee J, Wong J . Immunomodulator use in paediatric severe sepsis and septic shock. Ann Acad Med Singap. 2021; 50(10):765-772. View

19.

Werdan K, Pilz G, Bujdoso O, Fraunberger P, Neeser G, Schmieder R . Score-based immunoglobulin G therapy of patients with sepsis: the SBITS study. Crit Care Med. 2007; 35(12):2693-2701. View

20.

Turgeon A, Hutton B, Fergusson D, McIntyre L, Tinmouth A, Cameron D . Meta-analysis: intravenous immunoglobulin in critically ill adult patients with sepsis. Ann Intern Med. 2007; 146(3):193-203. DOI: 10.7326/0003-4819-146-3-200702060-00009. View