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논문 기본 정보

자료유형
학술저널
저자정보
최영운 (Department of Surgery Yonsei University Wonju College of Medicine Wonju Korea) 김준기 (Department of Surgery Yonsei University Wonju College of Medicine Wonju Korea) 장지영 (Department of Surgery National Health Insurance Service Ilsan Hospital Goyang Korea) Go Tae-Hwa (Department of Biostatistics Center of Biomedical Data Science Yonsei University Wonju College of Medicine Wonju Korea) 김광민 (Yonsei University Wonju College of Medicine) 배금석 (Department of Surgery Yonsei University Wonju College of Medicine Wonju Korea) 심홍진 (Department of Surgery Yonsei University Wonju College of Medicine Wonju Korea)
저널정보
대한중환자의학회 Acute and Critical Care Acute and Critical Care 제38권 제1호
발행연도
2023.2
수록면
21 - 30 (10page)
DOI
10.4266/acc.2022.01515

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Background The use of intravenous immunoglobulin (IVIG) in sepsis patients from bowel perforation is still debatable. However, few studies have evaluated the effect of IVIG as an adjuvant therapy after source control. This study aimed to analyze the effect of IVIG in critically ill patients who underwent surgery due to secondary peritonitis. Methods In total, 646 medical records of surgical patients who were treated for secondary peritonitis were retrospectively analyzed. IVIG use, initial clinical data, and changes in Sequential Organ Failure Assessment (SOFA) score over the 7-day admission in the intensive care unit for sepsis check, base excess, and delta neutrophil index (DNI) were analyzed. Mortalities and periodic profiles were assessed. Propensity scoring matching as comparative analysis was performed in the IVIG group and non-IVIG group. Results General characteristics were not different between the two groups. The survival curve did not show a significantly reduced mortality in the IVIG. Moreover, the IVIG group did not have a lower risk ratio for mortality than the non-IVIG group. However, when the DNI were compared during the first 7 days, the reduction rate in the IVIG group was statistically faster than in the non-IVIG group (P<0.01). Conclusions The use of IVIG was significantly associated with faster decrease in DNI which means faster reduction of inflammation. Since the immune system is rapidly activated, the additional use of IVIG after source control surgery in abdominal sepsis patients, especially those with immunocompromised patients can be considered. However, furthermore clinical studies are needed.

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