Expert consensus on the monitoring and treatment of sepsis-induced immunosuppression

Fei Pei; Ren-Qi Yao; Chao Ren; Soheyl Bahrami; Timothy R. Billiar; Irshad H. Chaudry; De-Chang Chen; Xu-Lin Chen; Na Cui; Xiang-Ming Fang; Yan Kang; Wei-Qin Li; Wen-Xiong Li; Hua-Ping Liang; Hong-Yuan Lin; Ke-Xuan Liu; Ben Lu; Zhong-Qiu Lu; Marc Maegele; Tian-Qing Peng; You Shang; Lei Su; Bing-Wei Sun; Chang-Song Wang; Jian Wang; Jiang-Huai Wang; Ping Wang; Jian-Feng Xie; Li-Xin Xie; Li-Na Zhang; Basilia Zingarelli; Xiang-Dong Guan; Jian-Feng Wu; Yong-Ming Yao

doi:10.1186/s40779-022-00430-y

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Expert consensus on the monitoring and treatment of sepsis-induced immunosuppression

POSITION ARTICLE AND GUIDELINES | Updated：2023-07-07

- Expert consensus on the monitoring and treatment of sepsis-induced immunosuppression
- Expert consensus on the monitoring and treatment of sepsis-induced immunosuppression
- MMR 2023年10卷第3期页码：281-298
- Affiliations：
  
  1.Department of Critical Care Medicine, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China
  2.Translational Medicine Research Center, Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General Hospital, Beijing 100853, China
  3.Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
  4.Ludwig-Boltzmann Institute for Experimental and Clinical Traumatology, 1200 Vienna, Austria
  5.Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
  6.Center for Surgical Research and Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35294, USA
  7.Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai 200025, China
  8.Department of Burns, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
  9.Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
  10.Department of Anesthesiology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 31003, China
  11.Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu 610041, China
  12.Department of Critical Care Medicine, General Hospital of Eastern Theater Command of Chinese PLA, Nanjing 210002, China
  13.Department of Surgical Intensive Critical Unit, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
  14.State Key Laboratory of Trauma, Burns and Combined Injury, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing 400042, China
  15.Department of Critical Care Medicine, Fourth Medical Center of the Chinese PLA General Hospital, Beijing 100048, China
  16.Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
  17.Department of Critical Care Medicine and Hematology, the Third Xiangya Hospital, Central South University, Changsha 410000, China
  18.Emergency Department, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang China
  19.Department of Traumatology and Orthopedic Surgery, University Witten-Herdecke, 51109 Cologne, Germany
  20.Critical Illness Research, Lawson Health Research Institute, London Health Sciences Centre, London, ON N6A 4G4, Canada
  21.Department of Critical Care Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
  22.Department of Intensive Care Unit, General Hospital of Southern Theater Command of Chinese PLA, Guangzhou 510030, China
  23.Department of Burns and Plastic Surgery, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215002, Jiangsu, China
  24.Department of Critical Care Medicine, Harbin Medical University Cancer Hospital, Harbin 150081, China
  25.Children’s Hospital of Soochow University, Pediatric Research Institute of Soochow University, Suzhou 215123, Jiangsu, China
  26.Department of Academic Surgery, University College Cork, Cork University Hospital, Cork T12 E8YV, Ireland
  27.Center for Immunology and Inflammation, the Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY 11030, USA
  28.Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
  29.Department of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China
  30.Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha 410008, China
  31.Division of Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 41073, USA
  32.Guangdong Clinical Research Center for Critical Care Medicine, Guangzhou 510080, China
- Author bio：
  
  * guanxd@mail.sysu.edu.cn;
  wujianf@mail.sysu.edu.cn;
  c_ff@sina.com
- Funds：
  
  grants from the National Natural Science Foundation of China(81730057;82130062);the Key Project of Military Medical Innovation Program of Chinese PLA(18CXZ026);the Guangdong Clinical Research Center for Critical Care Medicine(2020B1111170005);the Sun Yat-sen University Clinical Research Program 5010(2019002)
- DOI：10.1186/s40779-022-00430-y
  中图分类号：
- 纸质出版：2023-06
- Accepted：
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Expert consensus on the monitoring and treatment of sepsis-induced immunosuppression[J]. MMR, 2023,10(3):281-298.

Cite this article as: Pei F, Yao RQ, Ren C, Bahrami S, Billiar TR, Chaudry IH, et al. Expert consensus on the monitoring and treatment of sepsis-induced immunosuppression. Mil Med Res. 2022;9(1):74.
Expert consensus on the monitoring and treatment of sepsis-induced immunosuppression[J]. MMR, 2023,10(3):281-298. DOI： 10.1186/s40779-022-00430-y.

Cite this article as: Pei F, Yao RQ, Ren C, Bahrami S, Billiar TR, Chaudry IH, et al. Expert consensus on the monitoring and treatment of sepsis-induced immunosuppression. Mil Med Res. 2022;9(1):74. DOI： 10.1186/s40779-022-00430-y.

摘要

Abstract

Emerged evidence has indicated that immunosuppression is involved in the occurrence and development of sepsis. To provide clinical practice recommendations on the immune function in sepsis

an expert consensus focusing on the monitoring and treatment of sepsis-induced immunosuppression was developed. Literature related to the immune monitoring and treatment of sepsis were retrieved from PubMed

Web of Science

and Chinese National Knowledge Infrastructure to design items and expert opinions were collected through an online questionnaire. Then

the Delphi method was used to form consensus opinions

and RAND appropriateness method was developed to provide consistency evaluation and recommendation levels for consensus opinions. This consensus achieved satisfactory results through two rounds of questionnaire survey

with 2 statements rated as perfect consistency

13 as very good consistency

and 9 as good consistency. After summarizing the results

a total of 14 strong recommended opinions

8 weak recommended opinions and 2 non-recommended opinions were produced. Finally

a face-to-face discussion of the consensus opinions was performed through an online meeting

and all judges unanimously agreed on the content of this consensus. In summary

this expert consensus provides a preliminary guidance for the monitoring and treatment of immunosuppression in patients with sepsis.

关键词

Keywords

references

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