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Sepsis Treatment and Prophylaxis with Immunoglobulins: A Critical Appraisal

  • Conference paper
Yearbook of Intensive Care and Emergency Medicine

Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 1996))

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Abstract

The persistently high mortality of sepsis necessitates urgent therapeutic efforts to interrupt the toxin/mediator cascades by supplemental measures: by eliminating, neutralizing and antagonizing toxins and mediators, by antiinflammatory substances and by immunomodulation.

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References

  1. Sibbald WI, Vincent JL (1995) Round table conference on clinical trials for the treatment of sepsis. Chest 107: 522–527

    Article  PubMed  CAS  Google Scholar 

  2. Sprung CL, Caralis PV, Marcial EH, et al (1984) The effects of high-dose corticosteroids in patients with septic shock: A prospective, controlled study. N Engl J Med 311: 1137–1143

    Article  PubMed  CAS  Google Scholar 

  3. Bone RC, Fisher CJ, Clemmer TP, et al and the Methylprednisolone Severe Sepsis Study Group (1987) A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock. N Engl J Med 317: 653–658

    Article  PubMed  CAS  Google Scholar 

  4. The Veterans Administration Systemic Sepsis Cooperative Study Group (1987) Effect of high-dose glucocorticoid therapy on mortality in patients with clinical signs of systemic sepsis. N Engl J Med 317: 659–665

    Article  Google Scholar 

  5. Dhainaut JF, Tenaillon A, Le Tulzo Y, et al, the BN 52021 Sepsis Study Group (1994) Platelet activating factor receptor antagonist BN 52021 in the treatment of severe sepsis: A randomized, double-blind, placebo-controlled, multicenter clinical trial. Crit Care Med 22: 1720–1728

    PubMed  CAS  Google Scholar 

  6. Fisher CJ, Dhainaut JF, Opal SM, et al, for the Phase III rhIL-lra Sepsis Syndrome Study Group (1994) Recombinant human interleukin-1 receptor antagonist in the treatment of patients with sepsis syndrome: Results from a randomized, double-blind, placebo-controlled trial. JAMA 271: 1836–1843

    Article  PubMed  Google Scholar 

  7. Fisher CJ, Opal SM, Lowry SF, et al (1994) Role of interleukin-1 and the therapeutic potential of interleukin-1 receptor antagonist in sepsis. Circ Shock 44: 1–8

    PubMed  Google Scholar 

  8. Abraham E, Wunderink R, Silverman H, et al, for the TNFa MAb Sepsis Study Group (1995) Efficacy and safety of monoclonal antibody to human tumor necrosis factor a in patients with sepsis syndrome: A randomized, controlled, double-blind, multicenter clinical trial. JAMA 273: 934–941

    Article  PubMed  CAS  Google Scholar 

  9. Baumgartner JD, Glauser MP, McCutchan JA, et al (1985) Prevention of gram-negative shock and death in surgical patients by antibody to endotoxin core glycolipid. Lancet 8446: 59–63

    Article  Google Scholar 

  10. Ziegler EJ, McCutchan JA, Fierer J, et al (1982) Treatment of gram-negative bacteremia and shock with human antiserum to a mutant Escherichia coli. N Engl J Med 307: 1225–1230

    Article  PubMed  CAS  Google Scholar 

  11. Calandra T, Baumgartner JD (1995) Anti-endotoxin therapy. In: Sibbald WJ, Vincent JL (eds) Clinical trials for the treatment of sepsis (Update in intensive care and emergency medicine Vol 19). Springer, Berlin Heidelberg, pp 237–250

    Chapter  Google Scholar 

  12. McCloskey RV, Straube RC, Sanders C, Smith SM, Smith CR, and the CHESS Trial Study Group (1994) Treatment of septic shock with human monoclonal antibody HA-1A. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 121: 1–5

    PubMed  CAS  Google Scholar 

  13. Bone RC, Balk RA, Fein AM, et al, the E5 sepsis study group (1995) A second large controlled clinical study of E5, a monoclonal antibody to endotoxin: Results of a prospective, multicenter, randomized, controlled trial. Crit Care Med 23: 994–1006

    Article  PubMed  CAS  Google Scholar 

  14. Fink MP (1995) Another negative clinical trial of a new agent for the treatment of sepsis: Rethinking the process of developing adjuvant treatment for serious infections. Crit Care Med 23: 989–991

    Article  PubMed  CAS  Google Scholar 

  15. Ziegler EJ, Fisher CJ, Sprung CL, et al, and the HA-1A sepsis study group (1991) Treatment of gram-negative bacteremia and septic shock with HA-1A human monoclonal antibody against endotoxin: A randomized, double-blind, placebo-controlled trial. N Engl J Med 324: 429–436

    Article  PubMed  CAS  Google Scholar 

  16. Greenman RL, Schein RMH, Martin MA, et al, and the XOMA Sepsis Study Group (1991) A controlled clinical trial of E5 murine monoclonal IgM antibody to endotoxin in the treatment of gram-negative sepsis. JAMA 266: 1097–1102

    Article  PubMed  CAS  Google Scholar 

  17. Pilz G, Fateh-Moghadam S, Viell B, et al (1993) Supplemental immunoglobulin therapy in sepsis and septic shock: Comparison of mortality under treatment with polyvalent i.v. immunoglobulin versus placebo- Protocol of a multicenter, randomized, prospective, double-blind trial. Theor Surg 8: 61–83

    Google Scholar 

  18. Andersson JP, Andersson UG (1990) Human intravenous immunoglobulin modulates monokine production in vitro. Immunology 71: 372–376

    PubMed  CAS  Google Scholar 

  19. Poutsiaka DD, Clark BD, Vannier E, Dinarello CA (1991) Production of interleukin-1 receptor antagonist and interleukin-1β by peripheral blood mononuclear cells is differentially regulated. Blood 78: 1275–1281

    PubMed  CAS  Google Scholar 

  20. Andersson UG, Björk L, Skansen-Saphir U, Andersson JP (1993) Downregulation of cytokine production and interleukin-2 receptor expression by pooled human IgG. Immunology 79: 211–216

    PubMed  CAS  Google Scholar 

  21. Skansen-Saphir U, Andersson J, Bjork L, Andersson U (1994) Lymphokine production induced by streptococcal pyrogenic exotoxin-A is selectively downregulated by pooled human IgG. Eur J Immunol 24: 916–922

    Article  PubMed  CAS  Google Scholar 

  22. Darville T, Tabor D, Simpson K, Jacobs RF (1994) Intravenous immunoglobulin modulates human mononuclear phagocyte tumor necrosis factor-a production in vitro. Pediatr Res 35: 397–403

    Article  PubMed  CAS  Google Scholar 

  23. Bone RC, Balk RA, Cerra FB, et al (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest 101: 1644–1655

    Article  PubMed  CAS  Google Scholar 

  24. Burd RS, Cody CS, Dunn DL (1992) Immunotherapy of gram-negative bacterial sepsis. Landes, Austin

    Google Scholar 

  25. Cafiero F, Gipponi M, Bonalumi U, Piccardo A, Sguotti C, Corbetta G (1992) Prophylaxis of infection with intravenous immunoglobulins plus antibiotic for patients at risk for sepsis undergoing surgery for colorectal cancer: Results of a randomized, multicenter clinical trial. Surgery 112: 24–31

    PubMed  CAS  Google Scholar 

  26. The Intravenous Immunoglobulin Collaborative Study Group (1992) Prophylactic intravenous administration of standard immune globulin as compared with core-lipopolysaccharide immune globulin in patients at high risk of postsurgical infection. N Engl J Med 327: 234–240

    Article  Google Scholar 

  27. Schedel I, Dreickhausen U, Nentwig B, et al (1991) Treatment of Gram-negative septic shock with an immunoglobulin preparation. A prospective, randomized clinical trial. Crit Care Med 19: 1104–1113. Letters to the editor: Crit Care Med (1992) 20: 1364–1365 and (1993) 21: 163–165

    Article  PubMed  CAS  Google Scholar 

  28. Lehmkuhl P, Jeck-Thole S, Pichlmayr I (1991) Score-Systeme zur Kontrolle einer friihzeitigen Immunglobulintherapie bei Intensivpatienten. Intensivmed 28: 256–261

    Google Scholar 

  29. Class I, Schorer R (1989) Adjuvante Therapie mit Pseudomonas-Immunglobulin bei beatmeten Patienten einer operativen Intensivstation. Anasth Intensivther Notfallmed 24: 167–171

    Article  PubMed  CAS  Google Scholar 

  30. Stuttmann R, Hartert M, Coleman JE, Kill H, Germann G, Doehn M (1989) Prophylaxe mit einem Pseudomonas-Immunglobulin bei Brandverletzten. Intensivmed 26 (Suppl. 1): 130–137

    Google Scholar 

  31. Pilz G, Kreuzer E, Kääb S, Appel R, Werdan K (1994) Early sepsis treatment with immunoglobulins after cardiac surgery in score-identified high-risk patients. Chest 105: 76–82, errata in 105: 1924

    Article  PubMed  CAS  Google Scholar 

  32. Werdan K, Pilz G (1993) Immuntherapie der Sepsis: Immunglobuline, Endotoxinantikarper. In: Schuster HP (ed) Intensivtherapie bei Sepsis und Multiorganversagen. Springer, Berlin Heidelberg, pp 59–90

    Google Scholar 

  33. Pilz G, Appel R, Kreuzer E, Werdan K (1994) Comparison of early IgG vs. IgGMA administration in score-identified post-cardiac surgical patients at high risk for sepsis. Shock (Suppl 2): 12 (Abst)

    Google Scholar 

  34. Trautmann M, Held T (1990) Intravenöse Immunglobuline bei Septikämie und septischem Schock: Eine aktuelle Übersicht. Intensivmed 27: 225–232

    Google Scholar 

  35. Dominioni L, Dionigi R, Zanello M, et al (1991) Effects of high-dose IgG on survival of surgical patients with sepsis scores of 20 or greater. Arch Surg 126: 236–240

    PubMed  CAS  Google Scholar 

  36. Pilz G, Kaab S, Neeser G, et al (1991) Supplemental immunoglobulin (ivIgG) treatment in 163 patients with sepsis and septic shock: An observational study as a prerequisite for placebo-controlled clinical trials. Infection 19: 216–227

    Article  PubMed  CAS  Google Scholar 

  37. Werdan K, Melnitzki SM, Pilz G, Kapsner T (1989) The cultured rat heart cell: A model to study direct cardiotoxic effects of Pseudomonas endo- and exotoxins. In: Schlag G, Redl H (eds) Second Vienna Shock Forum (Progress in Clinical and Biological Research 308). Alan R Liss, New York, pp 247–251

    Google Scholar 

  38. Pilz G, Werdan K (1990) Cardiovascular parameters and scoring systems in the evaluation of response to therapy in sepsis and septic shock. Infection 18: 253–262

    Article  PubMed  CAS  Google Scholar 

  39. Chirico G, Rondini G, Plebani A, Chiara A, Massa M, Ugazio AG (1987) Intravenous gammmaglobulin therapy for prophylaxis of infection in high risk neonates. J Pediatr 110: 437–442

    Article  PubMed  CAS  Google Scholar 

  40. Baker CJ, Melish ME, Hall RT, et al, and the multicenter group for the study of immune globulin in neonates (1992) Intravenous immune globulin for the prevention of nosocomial infection in low-birth-weight neonates. N Engl J Med 327: 213–219

    Article  PubMed  CAS  Google Scholar 

  41. Baumgartner JD (1990) Arguments for the administration of immunoglobulins in critically ill patients. In: Peter K, Lawin P, Bein T, Briegel J (eds) Intensivmedizin 1990 (Intensivmedizin Notfallmedizin Anästhesie, Bd 81). Thieme, Stuttgart New York, pp 152–157

    Google Scholar 

  42. Pilz G, Gurniak T, Bujdoso O, Werdan K (1991) A BASIC program for calculation of APACHE II and Elebute scores and sepsis evaluation in intensive care medicine. Computer Biol Med 21: 143–159

    Article  CAS  Google Scholar 

  43. Duswald KH, Miiller K, Seifert J, Ring J (1980) Wirksamkeit von i.v. Gammaglobulin gegen bakterielle Infektionen chirurgischer Patienten- Ergebnisse einer kontrollierten, randomisierten klinischen Studie. Münch med Wschr 122: 832–836

    CAS  Google Scholar 

  44. Kress HG, Scheidewig C, Engelhardt W, Wallasch H, Elert O (1989) Prediction and prevention, by immunological means, of septic complications after elective cardiac surgery. In: Schlag G, Redl H (eds) Second Vienna Shock Forum (Progress in Clinical and Biological Research 308). Alan R Liss, New York, pp 1031–1035

    Google Scholar 

  45. Pilz G, Fraunberger P, Appel R, et al (1966) High soluble TNF receptor p55 concentrations early predict outcome in score-identified post-cardiac surgical patients at high risk for sepsis. Crit Care Med (In press)

    Google Scholar 

  46. Pilz G, Kaab S, Kreuzer E, Werdan K (1994) Evaluation of definitions and parameters for sepsis assessment in patients after cardiac surgery. Infection 22: 8–17

    Article  PubMed  CAS  Google Scholar 

  47. Miiller-Werdan U, Reithmann C, Werdan K (1996) Cytokines and the heart: Molecular mechanisms in septic cardiomyopathy (Chapter 9: Cytokines in non-septic heart diseases). Landes/Springer, Austin/Berlin Heidelberg (In press)

    Google Scholar 

  48. Vogel F (1988) Bewertung der intravenösen IgM-Therapie bei schweren nosokomialen Infektionen (Ergebnisse einer kontrollierten randomisierten Studie). In: Deicher H, Schoeppe W (eds) Klinisch angewandte Immunologie- Sepsistherapie mit IgM-angereichertem Immunglobulin. Springer, Berlin, pp 30–41

    Google Scholar 

  49. Spannbrucker N, Miinch HG, Kunze R, Vogel F (1987) Auswirkungen von Immunglobulinsubstitution bei Sepsis. Intensivmed 24: 314 (Abst)

    Google Scholar 

  50. Glinz W, Grob PJ, Nydegger UE, et al (1985) Polyvalent immunoglobulins for prophylaxis of bacterial infections in patients following multiple trauma: A randomized, placebo-controlled study. Intensive Care Med 11: 288–294

    Article  PubMed  CAS  Google Scholar 

  51. Just RM, Metzger M, Vogel W, Pelka RB (1985) Einfluß einer adjuvanten Immunglobulintherpie auf Infektionen bei Patienten einer operativen Intensiv-Therapie-Station-Ergebnisse einer randomisierten kontrollierten Studie. Klin Wochenschr 64: 245–256

    Article  Google Scholar 

  52. Jesdinsky HJ, Tempel G, Castrup JR, Seifert J (1987) Cooperative group of additional immunoglobulin therapy in severe bacterial infections: Results of a multicenter, randomized, controlled trial in cases of diffuse fibrinopurulent peritonitis. Klin Wochenschr 65: 1132–1138

    Article  PubMed  CAS  Google Scholar 

  53. De Simone C, Delogu G, Corbetta G (1988) Intravenous immunoglobulins in association with antibiotics: A therapeutic trial in septic intensive care patients. Crit Care Med 16:S23-S26

    Article  Google Scholar 

  54. Mao P, Enrichens F, Olivero G, et al (1989) Early administration of intravenous immunoglobulins in the prevention of surgical and post-traumatic sepsis: A double blind randomized clinical trial. Surg Res Comm 5: 93–98

    Google Scholar 

  55. Ranson JHC, Rifkind KM, Turner JW (1976) Prognostic signs and non-operative peritoneallavage in acute pancreatits. Surg Gynecol Obstet 143: 209–219

    PubMed  CAS  Google Scholar 

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Authors
  1. K. Werdan
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  2. G. Pilz
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Editor information

Editors and Affiliations

  1. Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent (Clinical Director) (Clinical Director)

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© 1996 Springer-Verlag Berlin Heidelberg

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Werdan, K., Pilz, G. (1996). Sepsis Treatment and Prophylaxis with Immunoglobulins: A Critical Appraisal. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine. Yearbook of Intensive Care and Emergency Medicine, vol 1996. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-80053-5_13

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  • DOI: https://doi.org/10.1007/978-3-642-80053-5_13

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-60552-2

  • Online ISBN: 978-3-642-80053-5

  • eBook Packages: Springer Book Archive

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