ABSTRACT
Despite improvements in postoperative supportive care and the development of new potent anti-infective agents, infection remains a major cause of mortality and morbidity among patients admitted to intensive care units after surgery or severe trauma. For instance, nosocomial pneumonia occurs in 7-30% of these patients (I); it is associated with mortality rates of 28-37% in recent series and lead to prolonged hospitalization duration for patients who survive (2). Another striking example of this problem is sepsis due to gram-negative bacteremia, whose mortality varies from 20% to 40% (3), reaching S0-15% in the case of development of septic shock (4,5). Several causes concur to the prevalence and the severity of infection in surgical and trauma patients: environmental factors, leading to selection of virulent and resistant micro-organisms; more aggressive surgical procedures in patients with more advanced underlying conditions; use of numerous devices, such as intravascular catheters, required for postoperative management; and alterations of immune defenses. The hope to diminish these alterations by administrating intravenous immunoglobulins (IVIG) has motivated several trials, in an attempt to prevent or to treat postoperative and posnrauma infection. In this chapter, we will first briefly review the rationale for use of MG, and then discuss the results of available trials.
