High-Dose Intravenous IgG for Treatment of Severe Surgical Infections

113 severely septic surgical patients, with an initial sepsis score ≧ 17 (mean: 23 ± 4) were prospectively randomized to receive either high-dose intravenous IgG (IVIG group) or placebo (control group), in addition to conventional multimodal intensive care. The two patient groups were comparable for the severity of the initial sepsis and for other relevant clinicopathologic parameters. Mortality was significantly lower in the IVIG group (33%) than in the control group (64%; p < 0.005). The beneficial effect of IVIG therapy was more evident in the subgroup of septic patients with a sepsis score in the range 20-25. Reduction of mortality was due to significantly lower mortality from septic shock (7% in the IVIG group vs. 29% in the control group; p < 0.01). IVIG therapy had no effect on mortality from multiple-organ failure (IVIG group: 25% vs. control group: 27%; p = NS).