ORIGINAL ARTICLE   Free access

Minerva Anestesiologica 2019 February;85(2):156-63

DOI: 10.23736/S0375-9393.18.12344-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Single versus divided administration of intravenous immunoglobulin for sepsis: a retrospective and historical control study

Kensuke NAKAMURA ¹ ✉, Ryota INOKUCHI ², Kazutaka FUKUSHIMA ¹, Hiromu NARABA ¹, Yuji TAKAHASHI ¹, Tomohiro SONOO ¹, Hideki HASHIMOTO ¹, Kent DOI ², Naoto MORIMURA ²

¹ Department of Emergency and Critical Care Medicine, Hitachi General Hospital, Hitachi, Japan; ² Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan

BACKGROUND: Intravenous immunoglobulin (IVIG) is regarded as effective, theoretically, for sepsis. The IVIG regimen for severe infection covered by Japanese health insurance is administration of 5 g/day for three days: an extremely low dosage. We investigated its effectiveness by comparison between divided dosage and single dosage of 15 g for one day.
METHODS: Patients who were admitted to our hospital’s Emergency Medical Center and treated with IVIG for sepsis were included and were analyzed retrospectively. The dosage regimen was 5 g for three days in the early half period, and 15 g for one day in the latter half period employing the same indication criteria.
RESULTS: Each group included 57 patients. No significant difference was found in their baseline characteristics, survival probability, or length of mechanical ventilation. However, the ICU stay and hospital stay lengths were shortened significantly by administration of the single dosage regimen. Disseminated intravascular coagulopathy markers and inflammatory indices were improved significantly earlier in the 15 g for one day group. Regarding adverse events, no significant difference was found.
CONCLUSIONS: For sepsis treatment, single administration of 15 g IVIG for one day improved the condition and inflammation earlier than divided dosage.

KEY WORDS: Intravenous immunoglobulin - Sepsis - Infection