Military Medical Research (Dec 2022)

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,
  • the Shock and Sepsis Society of Chinese Research Hospital Association,
  • the China Critical Care Immunotherapy Research Group,
  • the International Federation of the Shock Societies (IFSS)

DOI
https://doi.org/10.1186/s40779-022-00430-y
Journal volume & issue
Vol. 9, no. 1
pp. 1 – 18

Abstract

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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.

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