Çocuk Sağlığı ve Hastalıkları Dergisi 2005 , Vol 48 , Num 2
Does polyclonal intravenous immunoglobulin reduce mortality in septic children in the pediatric intensive care unit?
Dinçer Yıldızdaş1, Hacer Yapıcıoğlu2, Gökhan Tümgör3, Fatih Erbey4
1Çukurova Üniversitesi Tıp Fakültesi Pediatri Doçenti
2Çukurova Üniversitesi Tıp Fakültesi Pediatri Yardımcı Doçenti
3Çukurova Üniversitesi Tıp Fakültesi Pediatri Uzmanı
4Çukurova Üniversitesi Tıp Fakültesi Pediatri Araştırma Görevlisi
Yıldızdaş D, Yapıcıoğlu H, Tümgör G, Erbey F. (Department of Pediatrics, Çukurova University Faculty of Medicine, Adana, Turkey). Does polyclonal intravenous immunoglobulin reduce mortality in septic children in the pediatric intensive care unit? Çocuk Sağlığı ve Hastalıkları Dergisi 2005; 48: 136-141.

Although advances in medicine and our understanding of the pathogenesis of sepsis and septic shock have dramatically improved, the mortality rate in sepsis is still very high. The harmful effects of sepsis and septic shock have been postulated to be largely due to the lipid A component of the endotoxin molecule in gram-negative bacteria. Thus the use of antibodies against the endotoxin molecule in treatment has been investigated. There have been a number of studies about immunoglobulin preparations in the treatment of sepsis, and studies on monoclonal and polyclonal immunoglobulin preparations have increased. In this prospective randomized study, 84 patients followed in the Pediatric Intensive Care Unit for systemic inflammatory response syndrome were enrolled in the study. The patients with primary immune deficiency and chronic disease that may lead to immune deficiency were excluded. Intravenous immunoglobulin (IVIG) in a dose of 1 g/kg/day for two days was administered to 41 patients; 43 patients served as control. Of these 84 patients, 60 had blood culture-proven sepsis. The mean age of the patients was 32.6 ± 32.1 months. There was no statistical difference between groups (30 patients in IVIG group and 30 patients in control group) in terms of hospitalization days in the Pediatric Intensive Care Unit (10.8 ± 3.2 days vs 11 ± 3 days), ventilator treatment (33.3% vs 30%), septic shock (26.6% vs 39.9%), multiorgan dysfunction (36.6% vs 43.3%) and mortality rate (26.6% vs 33.2%), (p>0.05). In conclusion, as IVIG administration is very expensive and does not reduce mortality and morbidity, we think it is not necessary to initiate IVIG to septic children as an adjuvant therapy until further studies including a larger number of septic children are conducted. Anahtar Kelimeler : sepsis, çocuk, intravenöz immünoglobulin, sepsis, children, intravenous immunoglobulin

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