Prophylactic anti-lipopolysaccharide freeze-dried plasma in major burns: a double blind controlled trial.

A double-blind controlled trial to test the efficacy of freeze-dried plasma containing a high titre of anti-lipopolysaccharide (anti-LPS) IgG in preventing or reducing sepsis in burns was carried out on 60 consecutive consenting adult burn victims with burns between 20 and 55 per cent of body surface area. Statistics failed to demonstrate a reduction in the mortality (P = 0.12) but did demonstrate a reduction in the incidence of burn wound infection (P = 0.0443), a fall in endotoxin levels in the first week (P = 0.041) and a rise in the anti-endotoxin levels after 5 units of anti-LPS plasma (P = 0.027). The logistics of carrying out such a trial are difficult but a larger patient population and modification of the original protocol might demonstrate a significant fall in mortality and morbidity. It was felt that some of the positive benefits of the high titre anti-LPS plasma might be due to factors other than the anti-LPS IgG.