{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:14:49Z","timestamp":1790270089562,"version":"4.1.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2013,10,2]],"date-time":"2013-10-02T00:00:00Z","timestamp":1380672000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2013,10,2]],"date-time":"2013-10-02T00:00:00Z","timestamp":1380672000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Critical illness polyneuropathy and\/or myopathy (CIPNM) is a severe complication of critical illness. Retrospective data suggest that early application of IgM-enriched intravenous immunoglobulin (IVIG) may prevent or mitigate CIPNM. Therefore, the primary objective was to assess the effect of early IgM-enriched IVIG versus placebo to mitigate CIPNM in a prospective setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective, randomized, double-blinded and placebo-controlled trial, 38 critically ill patients with multiple organ failure (MOF), systemic inflammatory response syndrome (SIRS)\/sepsis, and early clinical signs of CIPNM were included. Patients were randomly assigned to be treated either with IgM-enriched IVIG or placebo over a period of three days. CIPNM was measured by the CIPNM severity sum score based on electrophysiological stimulation of the median, ulnar, and tibial nerves on days 0, 4, 7, 14 and on the histological evaluation of muscle biopsies on days 0 and 14 and ranged from 0 (no CIPNM) to 8 (very severe CIPNM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 38 critically ill patients were included and randomized to receive either IgM-enriched IVIG (n = 19) or placebo (n = 19). Baseline characteristics were similar between the two groups. CIPNM could not be improved by IVIG treatment, represented by similar CIPNM severity sum scores on day 14 (IVIG vs. placebo: 4.8 \u00b1 2.0 vs. 4.5 \u00b1 1.8;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.70). CIPNM severity sum score significantly increased from baseline to day 14 (3.5 \u00b1 1.6 vs. 4.6 \u00b1 1.9;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.002). After an interim analysis the study was terminated early due to futility in reaching the primary endpoint.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early treatment with IVIG did not mitigate CIPNM in critically ill patients with MOF and SIRS\/sepsis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      Clinicaltrials.gov:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\/ct2\/show\/NCT01867645\">NCT01867645<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/cc13028","type":"journal-article","created":{"date-parts":[[2013,10,2]],"date-time":"2013-10-02T07:01:54Z","timestamp":1380697314000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Early treatment with IgM-enriched intravenous immunoglobulin does not mitigate critical illness polyneuropathy and\/or myopathy in patients with multiple organ failure and SIRS\/sepsis: a prospective, randomized, placebo-controlled, double-blinded trial"],"prefix":"10.1186","volume":"17","author":[{"given":"Richard","family":"Brunner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Rinner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Haberler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhard","family":"Kitzberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Sycha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Herkner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Warszawska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Madl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Holzinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2013,10,2]]},"reference":[{"key":"1964_CR1","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1016\/S1474-4422(11)70178-8","volume":"10","author":"N Latronico","year":"2011","unstructured":"Latronico N, Bolton CF: Critical illness polyneuropathy and myopathy: a major cause of muscle weakness and paralysis.\n                           Lancet Neurol 2011, 10: 931-941. 10.1016\/S1474-4422(11)70178-8","journal-title":"Lancet Neurol"},{"key":"1964_CR2","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1136\/jnnp.49.5.563","volume":"49","author":"CF Bolton","year":"1986","unstructured":"Bolton CF, Laverty DA, Brown JD, Witt NJ, Hahn AF, Sibbald WJ: Critically ill polyneuropathy: electrophysiological studies and differentiation from Guillain-Barre syndrome.\n                           J Neurol Neurosurg Psychiatry 1986, 49: 563-573. 10.1136\/jnnp.49.5.563","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"1964_CR3","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1016\/S0165-5728(99)00252-0","volume":"106","author":"MA De Letter","year":"2000","unstructured":"De Letter MA, van Doorn PA, Savelkoul HF, Laman JD, Schmitz PI, Op de Coul AA, Visser LH, Kros JM, Teepen JL, van der Mech\u00e9 FG: Critical illness polyneuropathy and myopathy (CIPNM): evidence for local immune activation by cytokine-expression in the muscle tissue.\n                           J Neuroimmunol 2000, 106: 206-213. 10.1016\/S0165-5728(99)00252-0","journal-title":"J Neuroimmunol"},{"key":"1964_CR4","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1186\/cc7100","volume":"12","author":"G Hermans","year":"2008","unstructured":"Hermans G, De Jonghe B, Bruyninckx F, Van den Berghe G: Clinical review: critical illness polyneuropathy and myopathy.\n                           Crit Care 2008, 12: 238. 10.1186\/cc7100","journal-title":"Crit Care"},{"key":"1964_CR5","doi-asserted-by":"publisher","first-page":"1288","DOI":"10.1007\/s001340101009","volume":"27","author":"J Garnacho-Montero","year":"2001","unstructured":"Garnacho-Montero J, Madrazo-Osuna J, Garcia-Garmendia JL, Ortiz-Leyba C, Jimenez-Jimenez FJ, Barrero-Almodovar A, Garnacho-Montero MC, Moyano-Del-Estad MR: Critical illness polyneuropathy: risk factors and clinical consequences. 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