SynthesisIntensive care medicine2015
Endogenous IgG hypogammaglobulinaemia in critically ill adults with sepsis: systematic review and meta-analysis.
Synthesis in Intensive care medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 2 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- [S3 Guideline Sepsis-prevention, diagnosis, therapy, and aftercare : Long version].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2020Guideline
- Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016.Intensive care medicine · 2017Guideline
- Prognostic Significance of Immune Abnormalities in Children with Severe Sepsis: Authors' Reply.Indian journal of pediatrics · 2026Article
- Prognostic Significance of Immune Abnormalities in Children with Severe Sepsis.Indian journal of pediatrics · 2026Article
- Modes of (Inter)Actions of Polyvalent Immunoglobulins: Nonclinical and Clinical Research in Severe Bacterial Infections.Biomedicines · 2026Review
- Article
- Impact of different pathogen classes on the serumBBA advances · 2025Article
- Complement activation and humoral immune dysregulation drive progression of pediatric septic shock: a retrospective cohort study.American journal of translational research · 2025Article
- Longitudinal assessment of immunoglobulin response and disease progression in critically ill patients with community acquired pneumonia.Critical care (London, England) · 2024Article
- Diagnostic and prognostic significance of apelin-13, APJ for sepsis in the emergency department: A prospective study.Heliyon · 2024Article
- Clinical practice of sepsis-induced immunosuppression: Current immunotherapy and future options.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2024Review
- Intravenous immunoglobulin for mortality and inflammatory status in patients with sepsis: a retrospective database study.Frontiers in immunology · 2024Article
- Review
- The Role of the Intravenous IgA and IgM-Enriched Immunoglobulin Preparation in the Treatment of Sepsis and Septic Shock.Journal of clinical medicine · 2023Review
- Expert consensus on the monitoring and treatment of sepsis-induced immunosuppression.Military Medical Research · 2022Article
- Prediction of short-term mortality in elderly patients with sepsis using immunoglobulin G2: An observational study.Heliyon · 2022Article
- Sepsis-induced immunosuppression: mechanisms, diagnosis and current treatment options.Military Medical Research · 2022Review
- Precision medicine in sepsis and septic shock: From omics to clinical tools.World journal of critical care medicine · 2022Review
- Advances in Immune Monitoring Approaches for Sepsis-Induced Immunosuppression.Frontiers in immunology · 2022Review
- Higher levels of IgA and IgG at sepsis onset are associated with higher mortality: results from the Albumin Italian Outcome Sepsis (ALBIOS) trial.Annals of intensive care · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePlasma immunoglobulin concentrations are acutely altered in critically ill patients with sepsis. However, the association between immunoglobulin levels on the day of sepsis diagnosis and subsequent mortality is inconsistent.
methodsSystematic review of studies that report immunoglobulin measurements and mortality among adults with sepsis managed in a critical care setting. Fixed and random effect meta-analyses were conducted using low IgG levels as primary exposure and acute mortality as the primary outcome. Both variables were used as defined in individual studies.
resultsThe prevalence of a low immunoglobulin G (IgG) concentration on the day of sepsis diagnosis was variable [58.3% (IQR 38.4-65.5%)]. Three cut-off points (6.1, 6.5 and 8.7 g/L) were used to define the lower limit of IgG concentrations in the included studies. A subnormal IgG level on the day of sepsis diagnosis was not associated with an increased risk of death in adult patients with severe sepsis and/or septic shock by both fixed and random effect meta-analysis (OR [95% CI] 1.32 [0.93-1.87] and 1.48 [0.78-2.81], respectively).
conclusionsThis systematic review identifies studies of limited quality reporting heterogeneous sepsis cohorts with varying lower limits of normal for IgG. Although our data suggest that a subnormal IgG measurement on the day of sepsis diagnosis does not identify a subgroup of patients with a higher risk of death, further studies are needed to confirm or refute this finding, and whether optimal cut-offs and time windows can be defined for IgG measurement. This would determine whether patients receiving intravenous immunoglobulin therapy for sepsis could be stratified using IgG levels.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.