Effects of IgM-enriched immunoglobulin and fluid replacement on nerve conduction velocity in experimental sepsis

BACKGROUND Neuromuscular abnormalities in sepsis, termed critical illness polyneuropathy (CIP), have been suggested to be induced by inflammatory mechanisms and/or relative hypovolemia. CIP is characterized by early electrophysiological findings before the clinical symptoms. This study aimed to investigate the effect of intravenous immunoglobulin (IVIG) and volume replacement therapies on the possible nerve conduction velocity (NCV) alterations in the early phase of experimental sepsis. METHODS Forty-six Sprague-Dawley rats were randomly assigned to four groups. Cecal ligation/perforation was performed to induce experimental sepsis. NCV was assessed in the tail nerve. RESULTS There was no statistically significant difference in NCV levels within and among the Sham-operated, colloid-and IVIG-treated groups. In the sepsis without treatment group, there was a statistically significant decrease in NCV levels. CONCLUSION NCV is decreased in the early stage of experimental sepsis and it may be accepted as an early electrophysiological sign in CIP. Treatment with either IgM-enriched IVIG or early volume replacement appears to prevent the decrease in NCV in the early phase of experimental sepsis. Results were statistically indistinguishable between the IVIG- and colloid-treated groups. No statistical difference between these groups is noteworthy. There is a need to clarify the mechanisms of action with further randomized, clinical and experimental trials.