THE EFFECT OF PENTAGLOBIN THERAPY ON PROGNOSIS IN PATIENTS WITH SEVERE SEPSIS

This study was designed to assess the effects of polyclonal immunoglobulin administration on septic shock incidence and prognosis in patients with severe sepsis. Patients with severe sepsis were randomly allocated into two groups. One group (n= 21) received 5ml/kg/day/g Menriched immunglobulin preparation (Pentaglobin) for3 days. Other group did not receive immunoglobulins (n= 18). Simplified Organ Failure Assessment (SOFA) scores, leucocyte count, duration of mechanical ventilation, ICU stay, duration of severe sepsis did not show significant differences between the groups, as regards to septic shock incidence and mortality. However, a significant decrease in procalcitonin levels were detected only in patients who received pentaglobin (p = 0.001). Mortality rate was 5/21 (23.8 %) in pentaglobin group and 5/18 (27.7 %) in the control group. Although pentaglobin therapy could not achieve a statistically significant improvement in septic shock occurrence and mortality, the constant reduction in procalcitonin levels indicated the beneficial effects of immimotherapy on the severity of inflammatory response to infection in severe sepsis.

AÐIR SEPSÝS HASTALARINDA PENTAGLOBÝN TEDAVÝSÝNÝN PROGNOZ ÜZERÝNE ETKÝSÝ

Bu çalýþmada IgM ve IgA ile zenginleþtirilmiþ intravenöz immunglobulin preparatý olan Pentaglobin'in aðýr sepsisteki hastalarda septik þok geliþme insidansýna, klinik seyire, mortalite oranlarýna olan etkisi incelenmiþtir. Aðýr sepsis tanýsý alan hastalar randomize edilerek 2 gruba ayrýlmýþ, bir grup hastaya (n: 21) Pentaglobin solüsyonu 5 ml/kg/gün dozunda 3 gün süreyle uygulanmýþ, immunglobulin uygulanmayan hastalar (n=18) ise kontrol grubunu oluþturmuþtur. Prokalsitonin deðerleri pentaglobin uygulanan grupta istatistiksel anlamlý bir azalma göstermiþtir (p = 0.001). Gruplar arasýnda Simplified Organ Failure Assessment (SOFA) skoru, lökosit sayýsý, aðýr sepsis gün sayýsý, mekanik ventilasyon ve yoðun bakým kalýþ süresi ile septik þok geliþme insidansý ve mortalite açýsýndan anlamlý bir fark tespit edilmemiþtir. Pentaglobin grubunda 5 hasta (% 23.8), kontrol grubunda da 5 hasta (% 27.7) kaybedilmiþtir. Pentaglobin tedavisi her ne kadar septik þok geliþme insidansý ve mortaliteyi deðiþtirmese de prokalsitonin düzeylerinde görülen istikrarlý azalma, immünoterapinin inflamatuar yanýt üzerinde olumlu etkileri olduðunu düþündürmektedir.