The effects of adjuvant immunoglobulin M-enriched immunoglobulin therapy on mortality rate and renal function in sepsis-induced multiple organ dysfunction syndrome: retrospective analysis of intensive care unit patients.

OBJECTIVE: To determine the effect of immunoglobulin (Ig)M-enriched Ig therapy on mortality rate and renal function in sepsis-induced multiple organ dysfunction syndrome (MODS), using the Acute Physiology and Chronic Health Evaluation II (APACHE II) score. METHODS: Retrospective study of patients with sepsis-induced MODS treated with standard antibiotic plus supportive therapy (control group) or IgM-enriched Ig therapy adjuvant to control group therapy (IVIg group). Total length of stay in the intensive care unit (ICU), overall mortality rate and 28-day case fatality rate (CFR), as well as APACHE II scores and renal function parameters at day 1 and day 4 of therapy, were recorded. RESULTS: A total of 118 patients were included (control group, n = 62; IVIg group, n = 56). In both groups, day 4 APACHE II scores decreased significantly compared with day 1 scores; the effect of treatment on renal function was minimal. Length of ICU stay, overall mortality rate and 28-day CFR were significantly lower in the IVIg group compared with the control group. CONCLUSIONS: Adding IgM-enriched Ig therapy to standard therapy for MODS improved general clinical conditions and significantly reduced APACHE II scores, overall mortality rate and 28-day CFR, although effects on renal function were minimal.

High estradiol levels and depth of anaesthesia.

Estradiol is a steroid-structured hormone that has a periodic rhythm in the menstrual cycle. We aimed to evaluate the interference of high estradiol levels and the depth of anaesthesia. The study was performed on 44 females undergoing gynaelocologic surgery. Blood samples were performed for estradiol level before the procedures. BIS scores were recorded at 5-min intervals after induction and during the operation. Cases were assigned to three groups: Group 1 (n: 17) estradiol levels at or under 100 microg/dl, Group 2 (n: 14) levels were between 100 and 200 microg/dl and Group 3 (n: 13) levels were above 200 microg/dl. Estradiol levels were found to be 59.94 +/- 23.59 microg/dl in Group 1, 138.60 +/- 23.49 microg/dl in Group 2 and 239.30 +/- 41.08 microg/dl in Group 3. Significant differences were found between initial control and 10 and 80 min BIS levels. Anaesthetic consumption showed a decreased tendency in high estradiol cases. We concluded that an advanced clinical series should be performed to fully define the relationship between estradiol levels and anaesthesia depth.