Twenty RCTs (n=2,671) were included.
Five trials scored 1 on the Jadad scale, three scored 2, eight scored 3 and four scored 5.
Patients treated with IVIG had a significantly lower risk of death compared with control patients (pooled RR 0.74, 95% CI: 0.62, 0.89, p=0.001). There was no significant difference between the groups in length of ICU stay (5 trials) or days of mechanical ventilation (2 small trials).
The funnel plot provided no clear evidence of publication bias. The sensitivity analysis indicated that severe sepsis or septic shock, a dosage of 1 g/kg or more, and a duration of therapy longer than 2 days were associated with increased survival benefit and explained most of the heterogeneity between studies.