The overall concept: immunoglobulins as adjuvants for mediastinitis--does it make sense?

Supportive intravenous immunoglobulin (ivIg) treatment may reduce the incidence and severity of infections in a well-defined group of patients in intensive care, including those who have had cardiac surgery. Sternal wound infections and mediastinitis after cardiac surgery are to be investigated in the ATMI study with Pentaglobin. In this article I focus on optimising ivIg dosage, on likely mechanisms, on reasons why ivIg might improve a primarily gram-positive infection, and on the use of serial scoring as an endpoint in a trial of immunoglobulin.