Shock. 2024 Feb 7. doi: 10.1097/SHK.0000000000002336. Online ahead of print.
ABSTRACT
OBJECTIVES: To investigate the efficacy of intravenous immunoglobulin (IVIg) in treating sepsis-induced coagulopathy (SIC).
METHODS: A retrospective controlled analysis was conducted on 230 patients with SIC at Ganzhou People's Hospital from January 2016 to December 2022. All patients were screened using propensity score matching and treated according to the SSC2016 guidelines. Compared to the control group (n = 115), patients in the test group (n = 115) received IVIg (200 mg/kg.d) for 3 consecutive days post-admission. The rating scales, coagulation function, survival, and treatment duration were evaluated.
RESULTS: On day 3 of treatment, both groups exhibited reduced PLT and TEG-MA levels, with the control group showing a more significant decrease (P < 0.05). By the 5th day, these levels had recovered in both groups. However, the test group experienced a significant increase by day 7 (P < 0.05). Coagulation factors II and X began to increase on day 3, and normalization was significantly faster in the test group on day 5 (P < 0.05). The levels of PT, INR, APTT, D-dimer, FIB, FDP, TEG-R, and TEG-K exhibited a notable decline on day 3 and demonstrated significantly faster recovery on day 5 in the test group (P < 0.05). Additionally, both groups showed a reduction in APACHE II, SOFA, DIC, and LAC levels on day 3, but the test group's scores decreased significantly more by day 7 (P < 0.05). Within the test group, WBC count, CRP, PCT, IL-6, and Tmax levels were lower (P < 0.05). Furthermore, the test group demonstrated shorter duration for ICU stay, mechanical ventilation, and CRRT (P < 0.05). No significant differences were observed in the duration of fever or vasoactive drug use between the groups. However, the log-rank method indicated a higher 28-day survival rate in the test group (P < 0.05).
CONCLUSION: IVIg can successfully increase platelet count and coagulation factors, correct coagulation disorders, enhance organ function, and reduce 28-day mortality in patients with SIC.
PMID:38321608 | DOI:10.1097/SHK.0000000000002336