Intravenous immunoglobulin in critically ill adults: When and what is the evidence?
Identifieur interne : 002C18 ( Main/Exploration ); précédent : 002C17; suivant : 002C19Intravenous immunoglobulin in critically ill adults: When and what is the evidence?
Auteurs : J. Wang [Australie] ; Z K Mcquilten [Australie] ; E M Wood [Australie] ; C. Aubron [France]Source :
- Journal of critical care [ 1557-8615 ] ; 2015.
Descripteurs français
- KwdFr :
- Fasciite nécrosante (traitement médicamenteux), Humains, Immunoglobulines par voie veineuse (usage thérapeutique), Maladie grave, Myasthénie (traitement médicamenteux), Sepsie (traitement médicamenteux), Syndrome de Guillain-Barré (traitement médicamenteux), Syndrome de Stevens-Johnson (traitement médicamenteux).
- MESH :
- traitement médicamenteux : Fasciite nécrosante, Myasthénie, Sepsie, Syndrome de Guillain-Barré, Syndrome de Stevens-Johnson.
- usage thérapeutique : Immunoglobulines par voie veineuse.
- Humains, Maladie grave.
English descriptors
- KwdEn :
- MESH :
- chemical , therapeutic use : Immunoglobulins, Intravenous.
- drug therapy : Fasciitis, Necrotizing, Guillain-Barre Syndrome, Myasthenia Gravis, Sepsis, Stevens-Johnson Syndrome.
- Critical Illness, Humans.
Abstract
Intravenous immunoglobulin (IVIg) use is growing dramatically internationally due to the increasing numbers of acute and chronic conditions that may benefit from IVIg. Patients with conditions that may benefit from IVIg might require intensive care unit (ICU) admission, supporting the need to review IVIg use in the critical care setting. The most common clinical indications for IVIg in adults that may require ICU admission and are commonly supported under clinical practice guidelines are Guillain-Barré syndrome, myasthenia gravis and Lambert-Eaton myasthenic syndrome, inflammatory myopathies, and primary or secondary immunodeficiency diseases complicated by severe bacterial sepsis. Other emerging indications include necrotizing fasciitis, toxic epidermal necrolysis/Stevens-Johnson syndrome, and toxic shock syndrome. The evidence for IVIg use in sepsis and septic shock remains controversial and insufficient to recommend its routine use. Intravenous immunoglobulin is expensive and also carries risks of adverse effects, including common and benign infusion-related reactions, as well as relatively rare and more serious problems, such as thromboembolic events, renal failure, and aseptic meningitis. In this article, we review the literature on conditions requiring ICU admission and IVIg, and we classify them as supported, emerging, or unsupported indications based on the available evidence and guidelines for clinical use of IVIg.
DOI: 10.1016/j.jcrc.2015.01.022
PubMed: 25702845
Affiliations:
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<front><div type="abstract" xml:lang="en">Intravenous immunoglobulin (IVIg) use is growing dramatically internationally due to the increasing numbers of acute and chronic conditions that may benefit from IVIg. Patients with conditions that may benefit from IVIg might require intensive care unit (ICU) admission, supporting the need to review IVIg use in the critical care setting. The most common clinical indications for IVIg in adults that may require ICU admission and are commonly supported under clinical practice guidelines are Guillain-Barré syndrome, myasthenia gravis and Lambert-Eaton myasthenic syndrome, inflammatory myopathies, and primary or secondary immunodeficiency diseases complicated by severe bacterial sepsis. Other emerging indications include necrotizing fasciitis, toxic epidermal necrolysis/Stevens-Johnson syndrome, and toxic shock syndrome. The evidence for IVIg use in sepsis and septic shock remains controversial and insufficient to recommend its routine use. Intravenous immunoglobulin is expensive and also carries risks of adverse effects, including common and benign infusion-related reactions, as well as relatively rare and more serious problems, such as thromboembolic events, renal failure, and aseptic meningitis. In this article, we review the literature on conditions requiring ICU admission and IVIg, and we classify them as supported, emerging, or unsupported indications based on the available evidence and guidelines for clinical use of IVIg.</div>
</front>
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