Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Prevention of infection in multiple trauma patients by high-dose intravenous immunoglobulins
Autore:
Douzinas, EE; Pitaridis, MT; Louris, G; Andrianakis, I; Katsouyanni, K; Karmpaliotis, D; Economidou, J; Sfyras, D; Roussos, C;
Indirizzi:
Evangelismos Hosp, Dept Crit Care, Athens 10675, Greece Evangelismos HospAthens Greece 10675 pt Crit Care, Athens 10675, Greece Evangelismos Hosp, Div Immunol, Athens 10675, Greece Evangelismos Hosp Athens Greece 10675 Div Immunol, Athens 10675, Greece Univ Athens, Sch Med, Dept Hyg & Epidemiol, GR-11527 Athens, Greece Univ Athens Athens Greece GR-11527 & Epidemiol, GR-11527 Athens, Greece
Titolo Testata:
CRITICAL CARE MEDICINE
fascicolo: 1, volume: 28, anno: 2000,
pagine: 8 - 15
SICI:
0090-3493(200001)28:1<8:POIIMT>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
DOUBLE-BLIND; BACTERIAL-INFECTIONS; SURGICAL PATIENTS; PROPHYLAXIS; PNEUMONIA; TRIAL; RISK; CARE; BACTEREMIA; SEVERITY;
Keywords:
multiple trauma; intravenous immunoglobulins; infection prophylaxis; serum bactericidal activity; nosocomial pneumonia; positive blood cultures; complement components; IgG subclasses; injury severity score; Glasgow Coma Scale; nosocomial infection; catheter-related infection; Acute Physiology and Chronic Health Evaluation II;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
37
Recensione:
Indirizzi per estratti:
Indirizzo: Douzinas, EE Evangelismos Hosp, Dept Crit Care, 45-47 Ipsilandou St, Athens 10675, Greece Evangelismos Hosp 45-47 Ipsilandou St Athens Greece 10675 ce
Citazione:
E.E. Douzinas et al., "Prevention of infection in multiple trauma patients by high-dose intravenous immunoglobulins", CRIT CARE M, 28(1), 2000, pp. 8-15

Abstract

Objective: To investigate the activity of intravenous immunoglobulin (IVIG) as a prophylactic agent against infection in trauma victims. Design: Prospective, randomized, double-blind, placebo-controlled study. Setting: A 20-bed university intensive care unit. Patients: Thirty-nine trauma patients with injury severity scores (ISSs) of 16-50. Interventions: Penicillin was given at the time of admission and continuedat 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: Clinical variables related to infection were recorded. The complement components C3c, C4 and CH50, IgG, and the fractions of IgG were measured. The serum bactericidal activity (S8A) was assessed at 37 degrees C (98.6 degrees F) and 40 degrees C (104.0 degrees F) at the time of admission and during the course of IVIG administration. 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. Asignificantly 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 SEA 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 degrees C (104.0 degrees F) compared with 37 degrees C (98.6 degrees 5) (p < .0001) under all three conditions. In both groups, lowSEA (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: Trauma patients receiving high doses of IVIG exhibit a reduction of septic complications and an improvement of SEA. Early SEA measurement may represent an index of susceptibility to infection.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/09/20 alle ore 17:09:13