Adjuvant intravenous immunoglobulin in elderly sepsis: a randomized controlled study of mortality, organ function, and inflammation - Summary - MDSpire
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Adjuvant intravenous immunoglobulin in elderly sepsis: a randomized controlled study of mortality, organ function, and inflammation
To evaluate the efficacy and safety of intravenous immunoglobulin (IVIG) as an adjunct to conventional treatment in elderly patients with sepsis.
Approach:
Study Design: Single-center, prospective, open-label study with blinded outcome assessment.
Participants: 120 elderly patients (≥65 years) meeting Sepsis-3 criteria were randomized to receive IVIG plus conventional therapy or conventional therapy alone.
Intervention: IVIG was administered at 0.4 g/kg/day for 3 days.
Outcomes: Primary outcomes included 28-day all-cause mortality and change in Sequential Organ Failure Assessment (SOFA) score. Secondary outcomes included inflammatory markers, ICU length of stay, duration of mechanical ventilation, and adverse events.
Key Findings:
IVIG was associated with reduced 28-day mortality (18.3% vs. 31.7%; relative risk, 0.58; 95% CI, 0.31–0.97; p = 0.043).
SOFA scores declined more rapidly in the IVIG group (mean reduction at day 7: 3.7 vs. 2.1 points; p < 0.001).
CRP and PCT levels decreased more substantially with IVIG (p < 0.001 for both).
ICU stay was shorter in the IVIG group (9.8 vs. 12.4 days; p = 0.024).
Duration of mechanical ventilation was reduced in the IVIG group (4.2 vs. 5.7 days; p = 0.011).
Adverse events were infrequent and comparable between groups.
Interpretation:
Limitations:
Single-center study may limit generalizability.
Sample size may not be sufficient for broader conclusions.
