Cochrane · systematic review · CD001090
Intravenous immunoglobulin for treating sepsis, severe sepsis and septic shock
Alejandria, MM, Lansang, MAD, Dans, LF, et al. · Cochrane Database of Systematic Reviews · 2013 · Cochrane Library
Emergency and Critical CareAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
21
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 1 · 4.8%Low 3 · 14.3%Moderate 13 · 61.9%High 4 · 19%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Polyclonal intravenous immunoglobulin (IVIG) versus placebo or no intervention for sepsis, severe sepsis and septic shock
Population: neonates with sepsis, severe sepsis and septic shock
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality, neonates, standard polyclonal IVIG Polyclonal intravenous immunoglobulin (IVIG) vs placebo or no intervention | RR 1 [0.92, 1.08] | 5 studies · 3667 participants | Moderate |
All‐cause mortality, neonates, IgM‐enriched polyclonal IVIG Polyclonal intravenous immunoglobulin (IVIG) vs placebo or no intervention | RR 0.57 [0.31, 1.04] | 3 studies · 164 participants | Low Downgraded: imprecision |
Low risk of bias neonate studies, mortality all‐cause ‐ standard IVIG Polyclonal intravenous immunoglobulin (IVIG) vs placebo or no intervention | RR 1.01 [0.93, 1.09] | 3 studies · 3561 participants | High |
Polyclonal intravenous immunoglobulin (IVIG) versus placebo or no intervention for sepsis, severe sepsis and septic shock
Population: adult patients with sepsis, severe sepsis and septic shock
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality, adults, standard polyclonal IVIG Polyclonal intravenous immunoglobulin (IVIG) vs placebo or no intervention | RR 0.81 [0.7, 0.93] | 10 studies · 1430 participants | Moderate |
All‐cause mortality, adults, IgM‐enriched polyclonal IVIG Polyclonal intravenous immunoglobulin (IVIG) vs placebo or no intervention | RR 0.66 [0.51, 0.85] | 7 studies · 528 participants | Moderate |
Low risk of bias adult studies, by type of polyclonal IVIG, mortality all‐cause Polyclonal intravenous immunoglobulin (IVIG) vs placebo or no intervention | RR 0.97 [0.81, 1.15] | 5 studies · 945 participants | High |
Low risk of bias adult studies, mortality all‐cause ‐ standard IVIG Polyclonal intravenous immunoglobulin (IVIG) vs placebo or no intervention | RR 1.02 [0.84, 1.24] | 3 studies · 683 participants | High |
Low risk of bias adult studies, mortality all‐cause ‐ IgM‐enriched IVIG Polyclonal intravenous immunoglobulin (IVIG) vs placebo or no intervention | RR 0.82 [0.56, 1.19] | 2 studies · 262 participants | Moderate Downgraded: imprecision |
Monoclonal antibodies compared to placebo for sepsis, severe sepsis, septic shock
Population: patients with sepsis, severe sepsis, septic shock
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Anti‐endotoxins versus placebo, all‐cause mortality Monoclonal antibodies vs placebo | RR 0.92 [0.79, 1.06] | 8 studies · 4676 participants | Low Downgraded: risk of bias |
Anti‐endotoxin E5 versus placebo, all‐ cause mortality Monoclonal antibodies vs placebo | RR 0.98 [0.88, 1.1] | 4 studies · 1975 participants | Moderate Downgraded: risk of bias |
Anti‐endotoxin ‐ HA‐1A versus placebo, all‐cause mortality Monoclonal antibodies vs placebo | RR 0.8 [0.54, 1.2] | 3 studies · 2668 participants | Very low Downgraded: risk of bias, inconsistency |
Anti‐endotoxins Anti‐LPS versus placebo, all‐cause mortality Monoclonal antibodies vs placebo | RR 0.15 [0.02, 1.06] | 1 study · 33 participants | Low Downgraded: imprecision |
Sensitivity analysis by quality, anti‐endotoxin, all‐cause mortality Monoclonal antibodies vs placebo | RR 1.01 [0.94, 1.09] | 6 studies · 4443 participants | Moderate Downgraded: risk of bias |
Anti‐endotoxin, all‐cause mortality ‐ low risk of bias studies Monoclonal antibodies vs placebo | RR 0.67 [0.42, 1.05] | 1 study · 269 participants | Moderate Downgraded: imprecision |
Anti‐endotoxin, all‐cause mortality ‐ unclear risk of bias Monoclonal antibodies vs placebo | RR 1.03 [0.95, 1.11] | 5 studies · 4174 participants | Moderate Downgraded: risk of bias |
Monoclonal antibodies compared to placebo for sepsis, severe sepsis, septic shock
Population: patients with sepsis, severe sepsis, septic shock
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Anti‐cytokines versus placebo, all‐cause mortality Monoclonal antibodies vs placebo | RR 0.92 [0.86, 0.97] | 9 studies · 7893 participants | Moderate Downgraded: risk of bias |
Anticytokine ‐ anti‐TNF‐alpha versus placebo, all‐cause mortality Monoclonal antibodies vs placebo | RR 0.92 [0.87, 0.99] | 6 studies · 6200 participants | Moderate Downgraded: risk of bias |
Anti‐cytokines ‐ human interleukin‐1receptor antagonist versus placebo, all‐cause mortality Monoclonal antibodies vs placebo | RR 0.88 [0.76, 1.01] | 3 studies · 1693 participants | Moderate Downgraded: risk of bias |
Sensitivity analysis by quality, anti‐cytokine, all‐cause mortality Monoclonal antibodies vs placebo | RR 0.91 [0.86, 0.97] | 7 studies · 7752 participants | Moderate Downgraded: risk of bias |
Anti‐cytokine, all‐cause mortality ‐ low risk of bias studies Monoclonal antibodies vs placebo | RR 0.92 [0.86, 0.99] | 3 studies · 5065 participants | High |
Anti‐cytokine, all‐cause mortality ‐ uncertain risk of bias Monoclonal antibodies vs placebo | RR 0.89 [0.8, 1] | 4 studies · 2687 participants | Moderate Downgraded: risk of bias |