Effect of Interferon Gamma on Infection-Related Death in Patients With Severe InjuriesA Randomized, Double-blind, Placebo-Controlled Trial
David J. Dries, MD;
Gregory J. Jurkovich, MD;
Ronald V. Maier, MD;
Terry P. Clemmer, MD;
Steven N. Struve, MD;
John A. Weigelt, MD;
Gregory G. Stanford, MD;
Daniel L. Herr, MS, MD;
Howard R. Champion, FRCS(Edin);
Frank R. Lewis, MD;
David Hoyt, MD;
John Hansbrough, MD;
Albert E. Yellin, MD;
Thomas V. Berne, MD;
Donald D. Trunkey, MD;
Howard S. Jaffe, MD;
Catherine Munera, PhD;
Peggy Fisher;
Karen M. Starko, MD
Arch Surg. 1994;129(10):1031-1041.
Abstract
| |
Objective
To assess the efficacy of interferon gamma in reducing infection and death in patients sustaining severe injury.
Design
Multicenter, randomized, double-blind, placebo-controlled trial with observation for 60 days and until discharge for patients with major infection on day 60.
Setting
Nine university-affiliated level 1 trauma centers.
Patients
Four hundred sixteen patients with severe injuries, assessed by Injury Severity Score and degree of contamination.
Intervention
Recombinant human interferon gamma, 100 µg, was administered subcutaneously once daily for 21 days (or until patient discharge if prior to 21 days) as an adjunct to standard antibiotic and supportive therapy.
Main Outcome Measures
Incidence of major infection, death related to infection, and death.
Results
Infection rates were similar in both treatment groups; however, patients treated with interferon gamma experienced fewer deaths related to infection (seven [3%] vs 18 [9%]; P=.008) and fewer overall deaths (21 [10%] vs 30 [14%]; P=.17). While 12 early deaths (days 1 through 7) occurred in each treatment group, late death occurred in 18 placebo-treated patients and nine in interferon gamma—treated patients. The results were dominated by findings at one center, which had the highest enrollment and higher infection and death rates. Statistical analysis did not eliminate the possibility of an unidentified imbalance between arms as an explanation for the results.
Conclusion
Further evaluation is required to determine the validity of the observed reduction in infection-related deaths in patients treated with interferon gamma.
(Arch Surg. 1994;129:1031-1041)
Footnotes
See page 1040 for author affiliations.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Statins and sepsis
Gao et al.
Br J Anaesth 2008;100:288-298.
ABSTRACT
| FULL TEXT
Pathophysiology of Sepsis
Remick
Am. J. Pathol. 2007;170:1435-1444.
ABSTRACT
| FULL TEXT
Reprogramming of circulatory cells in sepsis and SIRS
Cavaillon et al.
Innate Immunity 2005;11:311-320.
ABSTRACT
Interferon-{gamma} increases monocyte HLA-DR expression without effects on glucose and fat metabolism in postoperative patients
de Metz et al.
J. Appl. Physiol. 2004;96:597-603.
ABSTRACT
| FULL TEXT
Prevention of nosocomial bacterial pneumonia
Vincent
Thorax 1999;54:544-549.
FULL TEXT
Hyporesponsiveness in leukocytes in sepsis: in vitro models reveal paradoxical effects of IL-10
Cavaillon et al.
Innate Immunity 1999;5:81-85.
ABSTRACT
Inhibition of the Defense System Stimulating Interleukin-12 Interferon-gamma Pathway During Critical Illness
Ertel et al.
Blood 1997;89:1612-1620.
ABSTRACT
| FULL TEXT
Interferon Gamma-1b in the Treatment of Compensatory Anti-inflammatory Response Syndrome: A New Approach: Proof of Principle
Kox et al.
Arch Intern Med 1997;157:389-393.
ABSTRACT
The clinical significance of endotoxin released by antibiotics: what is the evidence?
Mock et al.
Innate Immunity 1996;3:253-259.
ABSTRACT
Clinical Significance of Antibiotic Endotoxin-Releasing Properties in Trauma Patients
Mock et al.
Arch Surg 1995;130:1234-1241.
ABSTRACT
Preclinical and clinical evaluation of carbohydrate immunopharmaceuticals in the prevention of sepsis and septic sequelae
Williams et al.
Innate Immunity 1995;2:203-208.
ABSTRACT
|
