Intravenous immune globulin in the management of sepsis in PICU RSAB Harapan Kita, Jakarta
Keywords:
children, intravenous immune globulin, sepsis
Abstract
Background Sepsis is a major health problem and a leading causeof death among children. Intravenous immune globulin (IVIG)
has been reported in systemic inflammatory conditions.
Objective To determine the effectiveness of IVIG in the treatment
of sepsis in children.
Methods This was a hospital-based, retrospective study conducted
from 2000-2001. Sixty neonates and children under 18 years old
with sepsis were classified to either received or not received IVIG.
The IVIG and the non-IVIG groups were compared. Data was
obtained from medical records.
Results Of 60 sepsis cases, 16 were neonates (7 received IVIG, 9
did not), and 44 were infants and children (25 received IVIG
and 19 did not). In neonates, IVIG had no influence on mortality
(P=0.838), while in non-neonatal cases, it improved the survival
rate (P=0.010). The suitability of the 1st antibiotic influenced
the outcome and length of stay in neonatal cases (P=0.005), but
not in the non-neonatal group (P=0.111). Although in some
cases the 1 st antibiotic was not suitable, IVIG seemed to hold the
process for a while, giving more time to adjust to a suitable
antibiotic according to the culture result.
Conclusions The addition of IVIG to standard therapies revealed
minimum effect but showed benefit in holding the process, and
seemed to improve survival in children, but not in neonates.
References
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of sepsis. N Engl J Med 2003;348:138-50.
2. Randolph A. The purpose of the 1 st International Sepsis
Forum on Sepsis in Infants and Children. Pediatr Crit Care
Med 2005;6:S1-2.
3. Watson RS, Carcillo JA. Scope and epidemiology of pediatric
sepsis. Pediatr Crit Care Med 2005;6:S3-5.
4. Carcillo JA. Reducing the global burden of sepsis in infants
and children: a clinical practice research agenda. Pediatr Crit
Care Med 2005;6:S157-64.
5. Kazatchkine MD, Srini VK. Immunomodulation of
autoimmune and inflammatory diseases with intravenous
immune globulin. N Engl J Med 2001;345:747-55.
6. Wheeler PA, Bernard GR. Treating patients with severe
sepsis. N Engl J Med 1999; 340:207-14.
7. Russell JA. Management of sepsis. N Engl J Med 2006;
355:1699-713.
8. Khalid NH, Carr R, Modi N. Intravenous immunoglobulins
versus sepsis. Pediatrics 2000;105:1173-4.
9. Jenson HB, Pollock HB. Meta-analyses of the effectiveness
of intravenous immune globulin for prevention and treatment
of neonatal sepsis. Pediatrics 1997;99:e2.
Published
2007-10-31
How to Cite
1.
Mulyo G, Widjajanti M. Intravenous immune globulin in the management of sepsis in PICU RSAB Harapan Kita, Jakarta. PI [Internet]. 31Oct.2007 [cited 23Dec.2024];47(5):226-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/419
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Received 2016-09-01
Accepted 2016-09-01
Published 2007-10-31
Accepted 2016-09-01
Published 2007-10-31
