Effect of conventional treatment and immunoglobulin G, M and A combined with former one on mortality and morbidity of cases with severe sepsis and septic shock

Sepsis implies infection, which persists despite all therapeutic managements, and the response to the infection. Despite that arising improvements was noted in approaches of medical treatment, mortality is still high in the septic shock particularly with organ failure even in advanced medical centres. Main approaches to treat sepsis include an awareness of sepsis possibility, a systemic use of effective and broad-spectrum antibiotics and providing a supportive care on organ failure secondarity developed to sepsis. After approval was obtained from Clinical Studies Ethical Committee, School of Medicine of Karadeniz Technical University, data was retrospectively screened for patients who were hospitalized at anesthesiology intensive care unit between 2006 and 2012.Data of 1318 patients was screened.Data was analyzed for 95 patients, who met inclusion criteria.Among them, 47 were in immunoglubulin group and 48 were in the control group.Immunoglobulin group was given Ig G, A and M in addition to conventional sepsis therapy. Baseline data was analyzed in addition to data recorded 10 days after diagnosis of severe sepsis/septic shock was made. During follow-up period, significantly lower APACHE II scores were found at Day 2, 3, 4 and 6 in patients of Immunoglobulin group (p<0,05). Considering organ dysfunctions, GIS intolerance was lower (p<0.05).It was observed that Immunoglobulin group had less need to triplet vazopressor therapy (p<0.05).Positive correlation was noted between time of starting immunoglobulin and mechanical ventilation period and stay at intensive care unit (R:0,317, CI:%95, P=0,04, R:0,37, CI:%95, p:0,015, respectively).No significant difference was found between two groups in other follow-up period. In conclusion, although Ig G, A and M, added to standard of care, offered some positive outcomes in some parameters, no difference was observed in mechanical ventilation period, stay at ICU and mortality rate. According to international treatment guidelines, larger, prospective, randomized and controlled studies are required to evaluate routine use of Ig G, A and M in treatment of septic shock.