Abstract
The study of standard intravenous immunoglobulin G (IVIG) preparations as adjunctive therapy in seriously ill patients is motivated by the possible need to: restore immunoglobulin G levels depleted after trauma or surgery; and/or to provide patients with specific antibodies directed against various microorganisms. Whereas no therapeutic efficacy has been shown in clinical studies with standard IVIG, some data suggest a benefit in prophylactic use. Antisera or IVIG hyperimmune against the biologically active. highly conserved core portion of the endotoxin of Gram-negative bacteria have demonstrated variable degrees of protection in animal models and clinical trials. Two clinical trials using monoclonal antibodies against core lipopolysaccharide have been completed. Only subsets of patients with the Gram-negative sepsis syndrome were protected, but both studies gave discrepant results concerning the type of patients that were reported to benefit from administration of these antibodies. Further studies will be necessary to establish whether application of this therapy can be recommended.