Outcomes of ICU patients treated with intravenous immunoglobulin for sepsis or autoimmune diseases

Autoimmun Rev. 2022 Dec;21(12):103205. doi: 10.1016/j.autrev.2022.103205. Epub 2022 Oct 3.

Abstract

Objectives: To evaluate the outcomes of hospitalized patients in two intensive care units (ICU) treated with intravenous immunoglobulin (IVIg) added to standard-of-care therapy. The indications for IVIg therapy were sepsis or autoimmune disease.

Methods: We conducted a retrospective study involving adult patients with sepsis and autoimmune diseases, who received IVIg in the ICU at Wolfson and Sheba Medical Centers. A predefined chart was compiled on Excel to include a complete demographic collection, patient comorbidities, chronic medication use, disease severity scores (Charlson Comorbidity Index; SOFA and APACHE II index scores), indication and dosage of IVIg administration, duration of hospitalization and mortality rates.

Results: Patients (n - 111) were divided into 2 groups: patients with sepsis only (n-67) and patients with autoimmune disease only (n-44). Septic patients had a shorter ICU stay, received IVIg early, and had reduced mortality if treated with high dose IVIg. Patients with autoimmune diseases did not have a favorable outcome despite IVIg treatment. In this group, IVIg was administered later than in the sepsis group.

Conclusions: IVIg therapy improved the outcomes for ICU patients with sepsis.

Keywords: Autoimmune diseases; IVIg; Intensive care unit; Intravenous immunoglobulins; Sepsis; Septic shock.

Publication types

  • Review

MeSH terms

  • Adult
  • Autoimmune Diseases* / drug therapy
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Intensive Care Units
  • Retrospective Studies
  • Sepsis* / drug therapy

Substances

  • Immunoglobulins, Intravenous