Table 3 |
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Study results |
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|
Infection |
MOF, Mortality |
Inflammation |
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|
|
|
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|
Test intervention |
Study |
Test group (relative to control) |
Effect |
Test group (relative to control) |
Effect |
Test group (relative to control) |
Effect |
|
|
|
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|
Reduce immune paralysis |
Plasma expander |
Miller & Lim, 1985 [14] |
Mortality 0 vs 0 n.s. |
No effect |
immune reactive capacity n.s. |
No effect |
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|
Rizoli et al, 2006 [27] |
pneumonia 0.5% vs 0.5% n.s. |
No effect |
Mortality 0 vs 14.3% n.s., MOF score 1.68 vs 1.9 n.s. |
No effect |
WBC n.s.; decreased toward normal: CD11b, CD62L, CD16, and TNFα; increased toward normal: CD14, IL-1RA, and IL-10 all P < 0.05 |
SIRS↓ and CARS↓↑ |
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|
Bulger et al, 2008 [19] |
nosocomial infections 18.2% vs 15.2% n.s. |
No effect |
ARDS-free survival, MOF, mortality 29.1% vs 22.2% n.s. |
No effect |
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|
|
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|
Immuno-globulin |
Glinz et al, 1985 [20] |
any 47% vs 68% P = 0.02, pneumonia 37% vs 58% P = 0.01, sepsis 18% vs 26% n.s. |
↓ |
Mortality from infection* 12% vs 11% n.s. |
No effect |
acute phase proteins n.s. |
No effect |
|
|
Douzinas et al, 2000 [32] |
pneumonia 10% vs 61% P = 0.003 |
↓ |
Mortality rom infection* 0 vs 0 |
No effect |
C3 and CH50 n.s., C4 increased p = 0.04, increased serum bactericidal activity P < 0.000001 |
CARS↓ |
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|
|
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|
IFN- γ |
Polk et al, 1992 [22] |
major 39% vs 35%, minor 20% vs 28%, pneumonia 27% vs 24% n.s. |
No effect |
Mortality 9.2% vs 12.5% n.s. |
No effect |
HLA-DR increased P = 0.0001 |
CARS↓ |
|
|
Livingston et al, 1994 [31] |
major infection 48% vs 31% n.s. |
No effect |
WBC decreased P < 0.05, HLA-DR increased P < 0.05 |
SIRS↓ and CARS↓ |
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|
Dries et al, 1998 [18] |
major infection 49% vs 58% n.s. |
No effect |
Mortality 13% vs 42% P = 0.017 |
↓ |
TNFα, IL-1β, IL-2, IL-4, IL-6 n.s. |
No effect |
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|
Nakos et al, 2002 [26] |
ventilator-associated pneumonia 9% vs 50% p < 0.05 |
↓ |
Mortality 27% vs 40% n.s. |
No effect |
HLA-DR expression, IL-1β, phospholipase A2 all increasedP < 0.05; total cells in BAL and IL-10 decreased P < 0.01 |
SIRS↓ and CARS↓ |
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|
|
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|
Glucan |
Browder et al, 1990 [29] |
sepsis 9.5% vs 49% P < 0.05 |
↓ |
Mortality from sepsis* 0 vs 18% n.s. |
No effect |
IL-1β decreased P < 0.05, TNFα n.s. |
SIRS↓ |
|
|
de Felippe et al, 1993 [30] |
pneumonia 9.5% vs 55% P < 0.01, sepsis 9.9% vs 35% P < 0.05, either or both 14.3% vs 65% P < 0.001 |
↓ |
Mortality: general 23.5% vs 42.1%, related to infection 4.8% vs 30% P < 0.05 |
↓ |
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|
|
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|
Reduce hyper inflammation |
Superoxide dismutase |
Marzi et al, 1993 [25] |
Mortality 17% vs 8.3% n.s. MOF score n.s. |
No effect |
WBC count, CRP, PMN-elastase and IL-6 n.s.; phospholipase A2 and conjugated dienes decreased P < 0.05 |
SIRS↓ |
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|
Antithrombin III |
Waydhas et al, 1998 [28] |
Mortality 15% vs 5%, MOF 20% vs 30% n.s |
No effect |
soluble TNF receptor II, neutrophil elastase, IL-RA, IL-6, and IL-8 n.s. |
No effect |
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|
Anti-CD18 |
Rhee et al, 2000 [23] |
major and minor 38% vs 40% n.s. |
No effect |
Mortality 5.8% vs 6.7%, MOF score n.s. |
No effect |
WBC increased P-value not reported |
SIRS↑ |
|
|
Anti-L-Selectin |
Seekamp et al, 2004 [16] |
67% vs 55% n.s. |
No effect |
MOF n.s., mortality 11% vs 25% n.s. |
No effect |
WBC, IL-6, IL-10, neutrophil elastase, C3a, procalcitonin n.s. |
No effect |
|
|
Leukoreduced blood |
Nathens et al, 2006 [21] |
30% vs 36% n.s. |
No effect |
Mortality 19% vs 15% n.s. MOF score 6.6 vs 5.9 n.s. |
No effect |
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|
Perflubron |
Croce et al, 1998 [24] |
pneumonia 50% vs 3 75% n.s. |
No effect |
Mortality 8.3% vs 25% n.s. |
No effect |
WBC, neutrophils, IL-6, and IL-10 all decreased p < 0.01; capillary leak (BAL protein), TNFα, IL-1β, and IL-8 n.s. |
SIRS↓ |
|
|
Prostaglandin E1 |
Vassar et al, 1991 [15] |
sepsis 28% vs 30%, major wound inf. 65% vs 72%, n.s. |
No effect |
Mortality 26% vs 28%, ARDS 13% vs 32%, MOF 30% vs 32% n.s. |
No effect |
PMN superoxide production increased toward normal P < 0.02 |
CARS↓ |
|
|
|
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|
ARDS, acute respiratory distress syndrome; CARS, compensatory anti-inflammatory response syndrome; CRP, C-reactive protein; HLA, human leukocyte antigen; IL, interleukin; MOF, multiple organ failure; n.s., not significant; PMN, polymorphnuclear; SIRS, systemic inflammatory response syndrome; TNF, tumor necrosis factor; *, excluding deaths from cardiac arrhythmias secondary to a pulmonary embolus and myocardial infarction, intracranial pressure, and tracheostomy. |
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Spruijt et al. Critical Care 2010 14:R150 doi:10.1186/cc9218 |
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