EXPERIENCE WITH POLYCLONAL IMMUNOGLOBULIN THERAPY IN POLY TRAUMA PATIENTS WITH SEVERE SEPSIS
Keywords:Intravenous, Poly trauma, , Severe sepsis, SOFA score.
Objective: To evaluate the effects of intravenous immunoglobulin therapy on progression of severe sepsis in patients of poly trauma.
Design: Quasi-experimental study.
Place and Duration of Study: Combined Military Hospital Peshawar from June 2008 to Dec 2009.
Patients and Methods: Forty six patients of poly trauma with severe sepsis were included. Along with the standard management i.e., surgical management, fluid resuscitation, antibiotics, analgesics, ionotropic, ventilatory and nutritional support, IVIG 5% (intravenous immunoglobulin) was infused over a period of 6 hours and repeated for three consecutive days. Sequential Organ Failure Assessment (SOFA) score was used to assess the progress in all the patients.
Results: At the time of enrolment mean SOFA score was 5.41±1.127 and on the 15th day it was 1.62±2.24, mean age was 39.21+10.26 years. Thirty four patients (73.91%) developed gram negative sepsis and eighteen patients (39.13%) developed septic shock. Mean duration of stay in ICU and on ventilatory support was 20.80+9.61 and 10.52+5.52 days respectively. Thirty five days mortality rate of these patients was 30.43%.
Conclusion: The IVIG administration, when used along with the standard management appears to improve significantly the prognosis in patients of poly trauma with severe sepsis.