Background: Although some studies conducted outside of Japan have addressed the effectiveness of intravenous\r\nimmunoglobulins (IVIG) in treating infections, the dosing regimens and amounts used in Japan are very different\r\nfrom those reported. Here, we investigate the effectiveness of single-dose administration of IVIG in sepsis patients\r\nin Japan.\r\nMethods: We analyzed 79 patients admitted to the intensive care unit (ICU) of a tertiary care institution due to\r\nsevere sepsis or septic shock. Patients were randomly divided into a group that was administered standard divided\r\ndoses of IVIG (5 g/day for 3 days, designated the S group) or a group that was administered a standard single dose\r\nof IVIG (15 g/day for 1 day, H group); freeze-dried sulfonated human IVIG was used. The longitudinal assessment of\r\nprocalcitonin (PCT) levels, C-reactive protein (CRP) levels, white blood cell count, blood lactate levels, IL-6 levels,\r\nSequential Organ Failure Assessment (SOFA) score, and Systemic Inflammatory Response Syndrome (SIRS) was\r\nconducted. We also assessed mechanical ventilation duration (days), ICU stay (days), 28-day survival rate, and 90-day\r\nsurvival rate.\r\nResults: The study showed no significant differences in PCT levels, CRP levels, 28-day survival rate, and 90-day\r\nsurvival rate between the two groups. However, patients in the H group showed improvements in the various SIRS\r\ndiagnostic criteria, IL-6 levels, and blood lactate levels in the early stages after IVIG administration. In light of the\r\nnon-recommendation of IVIG therapy in the Surviving Sepsis Campaign Guidelines 2012, our findings of significant\r\nearly post-administration improvements are noteworthy. IVIG''s anti-inflammatory effects may account for the early\r\nreduction in IL-6 levels after treatment, and the accompanying improvements in microcirculation may improve\r\nblood lactate levels and reduce SOFA scores. However, the low dosages of IVIG in Japan may limit the anti-cytokine\r\neffects of this treatment. Further studies are needed to determine appropriate treatment regimens of single-dose\r\nIVIG.\r\nConclusions: In this study, we investigated the effectiveness of single-dose IVIG treatment in patients with severe\r\nsepsis or septic shock. Although there were no significant effects on patient prognoses, patients who were\r\nadministered single-dose IVIG showed significantly improved IL-6 levels, blood lactate levels, and disease severity\r\nscores.
Loading....