Intensive Care Medicine pp 142-149 | Cite as
Adjuvant Treatment of Mediastinitis with Immunoglobulins after Cardiac Surgery: The ATMI Trial
Abstract
Immunoglobulins constitute an innovative product group with a wide spectrum of clinical use. Intravenous immunoglobulin (IVIG) solutions containing IgG in a concentration of 95% or more were introduced in the fifties primarily for the treatment of patients with humoral immunodeficiencies. In primary and secondary humoral immunodeficiencies, intravenously administered immunoglobulins replace the natural immunoglobulins and subsequently maintain the natural function of the humoral immune system. In addition, since 1981, there has been a rapid expansion of use in autoimmune diseases, in particular T-cell- and B-cell-mediated chronic neuroinflammatory diseases. The administration of high-dose IVIG is now accepted for various immune-mediated neuropathies, e.g., in the treatment of Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, and multifocal motor-neuropathy. Furthermore the National Institutes of Health (NIH) consensus conference in 1990 set up a list of indications for which there was sufficient evidence to justify IVIG application: idiopathic thrombocytopenic purpura, hypogammaglobulinemia in chronic lymphatic leukemia patients, allogenic bone-marrow transplantation, and Kawasaki syndrome. The use of IVIG in the treatment of several inflammatory disorders is a more recent trend. Potential for the clinical use of immunoglobulins has been shown for inflammatory diseases/syndromes such as rheumatoid arthritis, immunovasculitis, dermatomyositis, sepsis, and others.
Keywords
Idiopathic Thrombocytopenic Purpura Discussion Forum Chronic Inflammatory Demyelinating Polyneuropathy Data Monitoring Committee Sternal DehiscencePreview
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