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[Level of immunoglobulins A, G and M in the postoperative period]
C Dressler1, K P Franke, M Herzig
1Abteilung für Anaesthesie und Intensivtherapie, Krankenhaus im Friedrichshain, Berlin.
There are very different points of view in the literature concerning the application of immunoglobulin preparations in the prophylaxis of septic complications or in the therapy of the sepsis syndrome. Indication for immunoglobulin substitution therapy with commercial products requires a critical new approach. Daily measurement of the immunoglobulin A, G and M serum levels may help in cases of deficiency. The high expectations placed in immunoglobulin therapy in cases of septic syndrome have not been fulfilled because of its complexity. Our own examinations were done to look for defects in the immunological system in the postoperative period and to make targeted substitutions. We compared the immunoglobulin levels in patients with and without postoperative septic complications. If there was a deficiency, we added 30-35 g Venimmun, but the immunological situation was not better than before, with regard to the serum levels. According to the literature, prophylaxis with immunoglobulin preparations is not useful to reduce the therapeutic period in an intensive care unit. The further development of septic complications, especially with regard to mortality, could not be influenced.
There are very different points of view in the literature concerning the application of immunoglobulin preparations in the prophylaxis of septic complications or in the therapy of the sepsis syndrome. Indication for immunoglobulin substitution therapy with commercial products requires a critical new approach. Daily measurement of the immunoglobulin A, G and M serum levels may help in cases of deficiency. The high expectations placed in immunoglobulin therapy in cases of septic syndrome have not been fulfilled because of its complexity. Our own examinations were done to look for defects in the immunological system in the postoperative period and to make targeted substitutions. We compared the immunoglobulin levels in patients with and without postoperative septic complications. If there was a deficiency, we added 30-35 g Venimmun, but the immunological situation was not better than before, with regard to the serum levels. According to the literature, prophylaxis with immunoglobulin preparations is not useful to reduce the therapeutic period in an intensive care unit. The further development of septic complications, especially with regard to mortality, could not be influenced.