학술논문

Prevention of infection in multiple trauma patients by high-dose intravenous immunoglobulins
Document Type
Academic Journal
Source
Critical Care Medicine. Jan 01, 2000 28(1):8-15
Subject
Language
English
ISSN
0090-3493
Abstract
OBJECTIVE:: DESIGN:: SETTING:: PATIENTS:: INTERVENTIONS:: Penicillin was given at the time of admission and continued at least until day 4. Twenty-one patients received IVIG and 18 patients received human albumin at 1 g/kg in four divided doses (days 1, 2, 3, and 6). The two groups had similarities in age, gender, Acute Physiology and Chronic Health Evaluation II score, risk of death, and Glasgow Coma Scale score, but differing ISSs (p = .02), at the time of admission. Blood was collected on days 1, 4, and 7. MEASUREMENTS AND MAIN RESULTS:: Controlling for ISS, IVIG-treated patients had fewer pneumonias (p = .003) and total non-catheter-related infections (p = .04). Catheter-related infections (p = .76), length of stay in the intensive care unit, antibiotic days, and infection-related mortality did not differ between the two groups. A significantly increased trend in IgG and its subclasses was shown on days 4 and 7 in the IVIG group but not in the control group (p < .000001). No important differences were noted in complement fractions. The SBA of the groups was similar on day 1, but significantly higher on days 4 and 7 (p < .000001) in the IVIG group, remaining so controlling for complement and ISS. SBA was higher at 40°C (104.0°F) compared with 37°C (98.6°F) (p < .0001) under all three conditions. In both groups, low SBA (on days 1, 4, and 7) was associated with increased risk of pneumonia (p < .01) and non-catheter-related infections (p = .06 for day 1; p < .01 for days 4 and 7). CONCLUSIONS