Abstract：
The therapeutic efficacy of intravenous immuneglobulin (IVIG) on children with septic shock remains uncertain. Therefore, we endeavored to investigate the impact of administering intravenous immunoglobulin (IVIG) in the pediatric intensive care unit (PICU) on patient with septic shock. We retrospectively analyzed the data of children admitted to the PICU due to septic shock from January 2017 to December 2021 in a tertiary pediatric hospital. The main outcome was in-hospital mortality. Total 304 patients were enrolled. There were no significant differences in the PRISM-III score (11 vs. 12, P = 0.907), PIM-3 score (0.08 vs. 0.07, P = 0.544), pSOFA score (10 vs. 10, P = 0.852) between the No IVIG group and the IVIG group. Children who received IVIG required more continuous renal replacement therapy (CRRT) support (43% vs. 24%, P = 0.001) and longer duration of mechanical ventilation (MV) (6 vs. 3 days, P = 0.002), and longer length of stay (LOS) of PICU (7 vs. 4 days, P = 0.001) and LOS of hospital (18 vs. 11 days, P = 0.001) than children who did not receive. The 28-day survival analysis (P = 0.033) showed better survival rates in IVIG group, while the in-hospital mortality (43% vs. 52%, P = 0.136) was no significant difference. In the propensity score matched analysis, 71 pairs were established. The length of CRRT (2 vs. 3 days, P = 0.744), duration of mechanical ventilation (5 vs. 4 days, P = 0.402), LOS of PICU (7 vs. 5 days, P = 0.216), LOS of hospital (18 vs. 13 days, P = 0.290), in-hospital mortality (44% vs. 44%, P = 1.000) and 28-day survival analysis (P = 0.748) were not statistically different. After inverse probability weighted analysis, there was still no difference in mortality between the two groups (51% vs. 48%, P = 0.665).
CONCLUSIONS: In children with septic shock, the use of intravenous immunoglobulin as an adjuvant therapy does not reduce in-hospital mortality.
BACKGROUND: • Guidelines suggest against the routine use of intravenous immuneglobulin in children with septic shock. Some small observational studies have reported conflicting result.
BACKGROUND: • The use of intravenous immunoglobulin as an adjuvant therapy does not reduce in-hospital mortality in children with septic shock.
CONCLUSIONS: In children with septic shock, the use of intravenous immunoglobulin as an adjuvant therapy does not reduce in-hospital mortality.
BACKGROUND: • Guidelines suggest against the routine use of intravenous immuneglobulin in children with septic shock. Some small observational studies have reported conflicting result.
BACKGROUND: • The use of intravenous immunoglobulin as an adjuvant therapy does not reduce in-hospital mortality in children with septic shock.
摘要：
静脉注射免疫球蛋白（IVIG）对感染性休克患儿的疗效尚不确定。因此,我们致力于研究儿科重症监护病房(PICU)静脉注射免疫球蛋白(IVIG)对感染性休克患者的影响.我们回顾性分析了2017年1月至2021年12月在三级儿科医院因感染性休克而进入PICU的儿童的数据。主要结果是院内死亡率。共纳入304例患者。PRISM-III评分无显著差异（11vs.12，P=0.907），PIM-3得分（0.08vs.0.07,P=0.544),pSOFA得分（10vs.10，P=0.852）在NoIVIG组和IVIG组之间。接受IVIG的儿童需要更多的连续性肾脏替代疗法（CRRT）支持（43％vs.24%,P=0.001）和更长的机械通气持续时间（MV）（6vs.3天,P=0.002),PICU的住院时间（LOS）更长（7vs.4天,P=0.001）和医院的LOS（18vs.11天,P=0.001）比没有接受的儿童。28天生存分析(P=0.033)显示IVIG组生存率较好,而住院死亡率(43%vs.52%,P=0.136)差别无统计学意义。在倾向得分匹配分析中，建立了71对。CRRT的长度(2vs.3天,P=0.744),机械通气的持续时间(5vs.4天,P=0.402),PICU的LOS（7vs.5天,P=0.216),医院的LOS（18vs.13天,P=0.290),住院死亡率（44%vs.44%,P=1.000）和28天生存分析（P=0.748）无统计学差异。经过逆概率加权分析，两组之间的死亡率仍然没有差异(51%vs.48%,P=0.665)。
结论：在感染性休克患儿中，静脉注射免疫球蛋白作为辅助治疗不能降低院内死亡率.
背景：•指南建议不对感染性休克患儿常规使用静脉注射免疫球蛋白。一些小型观察研究报告了相互矛盾的结果。
背景：•使用静脉注射免疫球蛋白作为辅助治疗并不能降低感染性休克患儿的住院死亡率。
结论：在感染性休克患儿中，静脉注射免疫球蛋白作为辅助治疗不能降低院内死亡率.
背景：•指南建议不对感染性休克患儿常规使用静脉注射免疫球蛋白。一些小型观察研究报告了相互矛盾的结果。
背景：•使用静脉注射免疫球蛋白作为辅助治疗并不能降低感染性休克患儿的住院死亡率。
