• Giorgio Berlot, Michele C Vassallo, Nicola Busetto, Monica Bianchi, Francesca Zornada, Ivana Rosato, Fabiana Tartamella, Lara Prisco, Federica Bigotto, Tiziana Bigolin, Massimo Ferluga, Irene Batticci, Enrico Michelone, Massimo Borelli, Marino Viviani, and Ariella Tomasini.
• Department of Anesthesia and Intensive Care, Cattinara University Hospital, Trieste, Italy. berlot@inwind.it
• J Crit Care. 2012 Apr 1;27(2):167-71.

PurposeBecause the use of IgM and IgA enriched polyclonal intravenous immunoglobulins (eIg) is a standard of care in critically ill patients admitted to our intensive care unit (ICU) with the diagnosis of severe sepsis or septic shock, we investigated if the delay from the onset of severe sepsis and septic shock and their administration could influence the outcome.Materials And MethodsThe medical records of all patients with severe sepsis or septic shock admitted to our ICU from July 2004 through October 2009 and treated with eIg (Pentaglobin®; Biotest, Dreieich, Germany) were retrospectively examined.ResultsA total of 129 adult patients with severe sepsis or septic shock were considered eligible. Thirty-two percent of patients died during the ICU stay. Survivors were given eIg significantly earlier than nonsurvivors (23 vs 63 hours, P < .05). The delay in the administration of eIg and the Simplified Acute Physiology Score II were the only variables that entered stepwise a propensity score-adjusted logistic model. The delay in the administration of eIg was a significant predictor of the odds of dying during the ICU stay (odds ratio for 1 hour of delay, 1.007; P < .01; 99% confidence interval from 1.001 to 1.010) and proved to be independent from the Simplified Acute Physiology Score II and other variables.ConclusionsThe efficacy of eIg, being maximal in early phases of severe sepsis and/or septic shock, is probably time dependent.Copyright © 2012 Elsevier Inc. All rights reserved.

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