The use of IgM-enriched immunoglobulin in adult patients with sepsis

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The administration of intravenous immunoglobulins (IVIG) is one of the adjunct therapies investigated and applied to sepsis patients, with the first studies being published nearly four decades ago. Intravenous immunoglobulin preparations have several mechanisms of action e.g. antigen neutralization, Fc-receptor blockade on phagocytic cells, modulation of cytokine responses and modulation of immune cell functions. The currently available evidence suggesting the use of intravenous immunoglobulins in sepsis is weak, but results from recent trials and systematic metanalyses seem more promising for the use of intravenous IgM-enriched immunoglobulins (IVIgGM) in septic patients. Nevertheless, the results of studies examining its value are contradicting. The purpose of this review is to summarize and present, clearly and thoroughly, the currently available data regarding established and future potential clinical uses of IVIgGM in patients with sepsis.HighlightsThe use of IVIgGM in sepsis syndrome has been evaluated for over 30 years.A large body of literature exists regarding the use of IVIgGM in sepsis syndrome.The additional cost for one additional life saved ranges between €5715 and €28,443.Standard use of IVIgGM is not currently part of the SSC guidelines.Large and well-designed RCTs are warranted before conclusive recommendations are made.

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