Low-dose immunoglobulin G is not associated with mortality in patients with sepsis and septic shock

Autor: Mineji Hayakawa, Alan Kawarai Lefor, Kohei Takimoto, Daisuke Kudo, Yusuke Iizuka, Nobuyuki Saito, Toru Miike, Hiroshi Takahashi, Kazuhiro Shiga, Ryosuke Sekine, Yoshiaki Yoshikawa, Masato Murata, Toshihiko Mayumi, Shodai Yoshihiro, Katsura Hayakawa, Fumihito Ito, Kensuke Umakoshi, Masahiro Yamane, Yoshihiko Nakamura, Masamitsu Sanui, Takafumi Todaka, Yutaka Kondo, Hideaki Arai, Naoto Hori, Yusuke Sasabuchi, Shigehiko Uchino, Tsuyoshi Nakashima, Kazuma Yamakawa, Yuya Kitai, Sho Nachi, Wataru Matsunaga, Motohiro Sekino, Takayuki Ogura, Keiko Ueno, Iwao Kobayashi, Akihito Tampo, Shuhei Takauji, Hiroki Takahashi, Yuko Okuda, Eiichiro Noda, Masayuki Watanabe, Takehiko Kasai, Kohkichi Andoh, Takeo Azuhata, Hiroshi Kodaira, Yoshiaki Iwashita, Shinjiro Saito
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
Propensity score
Subgroup analysis
Critical Care and Intensive Care Medicine
law.invention
Sepsis
03 medical and health sciences
0302 clinical medicine
Japan
Polyclonal intravenous immunoglobulin G
law
Internal medicine
Odds Ratio
medicine
Humans
Adjunctive therapy
Hospital Mortality
030212 general & internal medicine
Aged
Retrospective Studies
IVIG
Septic shock
business.industry
Research
lcsh:Medical emergencies. Critical care. Intensive care. First aid
030208 emergency & critical care medicine
Retrospective cohort study
lcsh:RC86-88.9
Odds ratio
Disseminated Intravascular Coagulation
Middle Aged
medicine.disease
Shock
Septic
Intensive care unit
Surgery
Intensive Care Units
Immunoglobulin G
Adjunctive treatment
Propensity score matching
Female
Infection
business
Zdroj: Critical Care, Vol 21, Iss 1, Pp 1-9 (2017)
Critical Care
ISSN: 1364-8535
DOI: 10.1186/s13054-017-1764-4
Popis: Background The administration of low-dose intravenous immunoglobulin G (IVIgG) (5 g/day for 3 days; approximate total 0.3 g/kg) is widely used as an adjunctive treatment for patients with sepsis in Japan, but its efficacy in the reduction of mortality has not been evaluated. We investigated whether the administration of low-dose IVIgG is associated with clinically important outcomes including intensive care unit (ICU) and in-hospital mortality. Methods This is a post-hoc subgroup analysis of data from a retrospective cohort study, the Japan Septic Disseminated Intravascular Coagulation (JSEPTIC DIC) study. The JSEPTIC DIC study was conducted in 42 ICUs in 40 institutions throughout Japan, and it investigated associations between sepsis-related coagulopathy, anticoagulation therapies, and clinical outcomes of 3195 adult patients with sepsis and septic shock admitted to ICUs from January 2011 through December 2013. To investigate associations between low-dose IVIgG administration and mortalities, propensity score-based matching analysis was used. Results IVIgG was administered to 960 patients (30.8%). Patients who received IVIgG were more severely ill than those who did not (Acute Physiology and Chronic Health Evaluation (APACHE) II score 24.2 ± 8.8 vs 22.6 ± 8.7, p
Databáze: OpenAIRE
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