Les immunoglobulines intraveineuses pour le choc septique: une enquête nationale canadienne auprès des médecins intensivistes et spécialistes des maladies infectieuses

Translated title of the contribution: Intravenous immune globulin in septic shock: a Canadian national survey of critical care medicine and infectious disease specialist physicians

Murdoch Leeies, Hayley B. Gershengorn, Emmanuel Charbonney, Anand Kumar, Dean Fergusson, Alexis F. Turgeon, Juthaporn Cowan, Bojan Paunovic, John Embil, Allan Garland, Donald S. Houston, Brett Houston, Emily Rimmer, Faisal Siddiqui, Bill Cameron, Srinivas Murthy, John C. Marshall, Rob Fowler, Ryan Zarychanski

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Purpose: This national survey evaluated the perceived efficacy and safety of intravenous immune globulin (IVIG) in septic shock, self-reported utilization patterns, barriers to use, the population of interest for further trials and willingness to participate in future research of IVIG in septic shock. Methods: We conducted a cross-sectional survey of critical care and infectious diseases physicians across Canada. We summarized categorical item responses as counts and proportions. We developed a multivariable logistic regression model to identify physician-level predictors of IVIG use in septic shock. Results: Our survey was disseminated to 674 eligible respondents with a final response rate of 60%. Most (91%) respondents reported having prescribed IVIG to patients with septic shock at least once, 86% for septic shock due to necrotizing fasciitis, 52% for other bacterial toxin-mediated causes of septic shock, and 5% for undifferentiated septic shock. The majority of respondents expressed uncertainty regarding the impact of IVIG on mortality (97%) and safety (95%) in septic shock. Respondents were willing to participate in further IVIG research with 98% stating they would consider enrolling their patients into a trial of IVIG in septic shock. Familiarity with published evidence was the single greatest predictor of IVIG use in septic shock (odds ratio, 10.2; 95% confidence interval, 3.4 to 30.5; P < 0.001). Conclusions: Most Canadian critical care and infectious diseases specialist physicians reported previous experience using IVIG in septic shock. Respondents identified inadequacy of existing research as the greatest barrier to routine use of IVIG in septic shock. Most respondents support the need for further studies on IVIG in septic shock, and would consider enrolling their own patients into a trial of IVIG in septic shock.

Translated title of the contributionIntravenous immune globulin in septic shock: a Canadian national survey of critical care medicine and infectious disease specialist physicians
Original languageFrench
Pages (from-to)782-790
Number of pages9
JournalCanadian Journal of Anesthesia
Volume68
Issue number6
DOIs
StatePublished - Jun 2021

Keywords

  • immunomodulation
  • intravenous immune globulin
  • IVIG
  • sepsis
  • septic shock

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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