{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T02:48:51Z","timestamp":1791600531445,"version":"4.3.4"},"reference-count":40,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Evidence for adjunctive intravenous immunoglobulin therapy in sepsis remains conflicting. This study evaluated the association of IgM- and IgA-enriched polyclonal intravenous immunoglobulin (IgGAM) therapy with clinical outcomes, including post hoc analyses according to initial empiric antibiotic therapy (IEAT) appropriateness. Methods: This single-center retrospective cohort study included 50 adults with sepsis or septic shock according to Sepsis-3 criteria, treated between November 2006 and March 2010. Twenty-five patients received adjunctive IgGAM plus standard sepsis management, and 25 received standard management alone. Primary outcomes were 28-day intensive care unit (ICU) mortality, overall ICU mortality, and in-hospital mortality. Results: Overall, 28-day ICU mortality was 28.0% with IgGAM and 32.0% with control (relative risk, 0.88; 95% confidence interval [CI], 0.37\u20132.05; p = 0.758); other mortality outcomes did not differ significantly. Kaplan\u2013Meier survival distributions also did not differ significantly (log-rank p = 0.208). During the ICU stay, vasopressor therapy was required in 68% of the IgGAM group and 92% of the control group (p = 0.034); corresponding study day 1 requirements were 60% and 76% (p = 0.225). In the complete-case longitudinal analysis (IgGAM group, n = 20; control group, n = 25), SOFA scores decreased significantly over time within the IgGAM group (p = 0.017), whereas no significant within-group change was observed in the control group (p = 0.616). In the post hoc appropriate-IEAT subgroup, 28-day ICU mortality was 0.0% versus 36.8% (p = 0.026), in-hospital mortality was 25.0% versus 63.2% (p = 0.038), and Kaplan\u2013Meier survival distributions differed significantly (log-rank p = 0.004). The 60-day restricted mean survival time was 58.1 versus 38.4 days, with a difference of 19.8 days (95% CI, 11.1\u201328.4). Conclusions: Adjunctive IgGAM therapy was not associated with significant differences in mortality overall. Findings in the post hoc appropriate-IEAT subgroup were hypothesis-generating and should be interpreted cautiously given potential selection bias, residual confounding, and multiple comparisons. Prospective evaluation within optimized sepsis care is warranted.<\/jats:p>","DOI":"10.3390\/jcm15197731","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:40:17Z","timestamp":1791596417000},"page":"7731","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["IgM- and IgA-Enriched Polyclonal Intravenous Immunoglobulin Therapy in Sepsis: A Single-Center Retrospective Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9978-6370","authenticated-orcid":false,"given":"Hakan","family":"Y\u0131lmaz","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Faculty of Medicine, Ankara University, 06230 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"given":"Melek","family":"Tulunay","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Faculty of Medicine, Ankara University, 06230 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"given":"Ali Abbas","family":"Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Faculty of Medicine, Ankara University, 06230 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S0140-6736(19)32989-7","article-title":"Global, regional, and national sepsis incidence and mortality, 1990-2017: Analysis for the Global Burden of Disease Study","volume":"395","author":"Rudd","year":"2020","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1186\/s13054-019-2478-6","article-title":"Frequency and mortality of septic shock in Europe and North America: A systematic review and meta-analysis","volume":"23","author":"Vincent","year":"2019","journal-title":"Crit. 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