Immunoglobulins and sepsis

Shankar-Hari, Manu; Madsen, Martin Bruun; Turgeon, Alexis F.

doi:10.1007/s00134-018-5047-6

Cited by 15 publications

(19 citation statements)

References 16 publications

(23 reference statements)

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“…The latter may be represented by potential treatments for sepsis that are based more specifically on etiological, organ dysfunction, and immunologic factors. 64,68 More abstractly, for any given patient in the ICU, there exist a set of recorded variables; the values of these variables, as well as the presence or absence of such data, and even the time of the data collection collectively define an interaction between the patient and the caregivers. Furthermore, each of these collections of patient variables is an element of a data mart which defines the interaction between the ICU's population, the system within which the ICU exists, and the ICU's caregivers.…”

Section: Toward a Precision Critical Carementioning

confidence: 99%

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Critical Care, Critical Data

Celi

Stone

2019

Biomed Eng Comput Biol

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As big data, machine learning , and artificial intelligence continue to penetrate into and transform many facets of our lives, we are witnessing the emergence of these powerful technologies within health care. The use and growth of these technologies has been contingent on the availability of reliable and usable data, a particularly robust resource in critical care medicine where continuous monitoring forms a key component of the infrastructure of care. The response to this opportunity has included the development of open databases for research and other purposes; the development of a collaborative form of clinical data science intended to fully leverage these data resources, and the creation of data-driven applications for purposes such as clinical decision support. Most recently, data levels have reached the thresholds required for the development of robust artificial intelligence features for clinical purposes. The systematic capture and analysis of clinical data in both individuals and populations allows us to begin to move toward precision medicine in the intensive care unit (ICU). In this perspective review, we examine the fundamental role of data as we present the current progress that has been made toward an artificial intelligence (AI)-supported, data-driven precision critical care medicine.

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Section: Toward a Precision Critical Carementioning

confidence: 99%

“…The latter may be represented by potential treatments for sepsis that are based more specifically on etiological, organ dysfunction, and immunologic factors. 64,68…”

Section: Toward a Precision Critical Carementioning

confidence: 99%

Critical Care, Critical Data

Celi

Stone

2019

Biomed Eng Comput Biol

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“…To our knowledge, this was the first study to evaluate the relationship between the levels of Igs, WBCs and lymphocytes do not increase the risk of death, low levels of multiple endogenous Igs have been found to increase the mortality risk in these patients [8,[12][13][14].…”

Section: Discussionmentioning

confidence: 89%

“…Most patients with sepsis present with low concentrations of Igs. Immunomodulatory therapies with intravenous Ig (IVIG) or IgMenriched IVIG (IVIGAM) are considered as potential adjuvant therapy for these patients [12][13][14][15]. Sepsis is characterised by functional, phenotypic and quantitative changes in T and B lymphocytes.…”

Section: Introductionmentioning

confidence: 99%

Correlation of Immunoglobulins and Lymphocytes Levels With the Clinical and Microbiological Response of Septic Patients With Gram-Negative Bacteremia

et al. 2021

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Background Immunoglobulins (Igs) and cells of the innate and adaptive immune systems play a critical role in a host’s response to sepsis. The aim of this study was to investigate the possible differences in the levels of Igs, white blood cells (WBCs), and T and B lymphocytes cells in relation to the microbiological and clinical responses of patients with sepsis or septic shock from carbapenem non-susceptible Gram-negative bacteria (CnS-GNB). Methods This pilot cohort study involved 24 hospitalized patients with sepsis or septic shock due to bacteremia from CnS-GNB. The microbiological and clinical responses of the patients were evaluated in relation to their blood levels of IgA, IgE, IgM and IgG, as well as WBCs and subpopulations of T and B cells upon sepsis diagnosis. A microbiological response was determined as clearance of bacteremia at 14 days of active antibiotic treatment for the isolated bacterial pathogen. Clinical response was defined as the resolution of all clinical and laboratory signs of infection and sepsis at 14 days of active antibiotic treatment for the isolated pathogen. Results From the 24 patients included in the study 18 (75%) and six patients (25%) presented and did not present microbiological response respectively, while 16 patients presented clinical response (64%) and eight patients (36%) did not have clinical response. The levels of the Igs did not show statistically significant differences between patients with sepsis from CnS-GNB bacteremia who exhibited microbiological or clinical response. There were also no statistically significant differences in the levels of WBCs and the subpopulations of T and B cells levels for these patients (P > 0.05). According to this pilot study, peripheral blood Igs and lymphocyte subpopulations levels do not affect the clinical and microbiological response of septic patients with bacteremia from CnS-GNB. Conclusions In patients with sepsis or septic shock from CnSGNB, there were no differences in the levels of Igs, circulating WBCs and T and B cells subpopulations between those with microbiological or clinical response and non-responders.

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“…Despite sound biological plausibility for using intravenous immunoglobulin as adjuvant therapy in sepsis, i.e., altered immunoglobulin and B-lymphocyte homeostasis in sepsis, the quality of evidence for its use is very low with no firm evidence for benefit or harm [9,10]. Accordingly, the authors requested that more research is needed prior to using intravenous immunoglobulins as adjuvant therapy in patients with sepsis [9,10].…”

mentioning

confidence: 99%

Focus on sepsis

2019

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Compliance with ethical standards Conflicts of interest WA is the methods Chair of the adult and children Surviving Sepsis Campaign Guidelines. MHM is a methodologist in the adult Surviving Sepsis Campaign guideline and a panel member of the children Surviving Sepsis Campaign guideline. MHM and MS-H are on the Editorial Board for ICM and declares no competing interests. All authors are active researchers within the field of sepsis.

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Immunoglobulins and sepsis

Cited by 15 publications

References 16 publications

Critical Care, Critical Data

Critical Care, Critical Data

Correlation of Immunoglobulins and Lymphocytes Levels With the Clinical and Microbiological Response of Septic Patients With Gram-Negative Bacteremia

Focus on sepsis

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