Observational studyShock (Augusta, Ga.)2018
Evidence for Persistent Immune Suppression in Patients Who Develop Chronic Critical Illness After Sepsis.
Observational study in Shock (Augusta, Ga.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 85 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
85 citing papers in PubMed, 3 syntheses or guidelines pooled it, 136 citations in OpenAlex.
- Prognostic value of the prognostic nutritional index in sepsis, pneumonia, and tuberculosis: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
- A bibliometric and visual analysis of research trends and hotspots in sepsis-related immunosuppression (2005-2025).Frontiers in pharmacology · 2026Pooled it
- Efficacy of thymosin α1 for sepsis: a systematic review and meta-analysis of randomized controlled trials.Frontiers in cellular and infection microbiology · 2025Pooled it
- Persistent immune, coagulation and cardiac dysregulation are correlated with later post-discharge mortality in children with severe malnutrition.BMC medicine · 2026Trial
- [A prospective randomized controlled study on the curative effects of enteral immunonutrition support therapy in adult burn patients at nutritional risk].Zhonghua shao shang yu chuang mian xiu fu za zhi · 2022Trial
- Clinical characteristics and risk factors associated with ICU-acquired infections in sepsis: A retrospective cohort study.Frontiers in cellular and infection microbiology · 2022Trial
- Immune checkpoint inhibition in sepsis: a Phase 1b randomized study to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of nivolumab.Intensive care medicine · 2019Trial
- Immune Checkpoint Inhibition in Sepsis: A Phase 1b Randomized, Placebo-Controlled, Single Ascending Dose Study of Antiprogrammed Cell Death-Ligand 1 Antibody (BMS-936559).Critical care medicine · 2019Trial
- Persistent lymphopaenia in critically ill patients with and without sepsis: An Australian and New Zealand point prevalence study.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Persistent Inflammation, Immunosuppression, and Catabolism Syndrome and Serious Infections in Burn-Injured Adults: A Retrospective Single-Center Study from 1997 to 2023.Journal of burn care & research : official publication of the American Burn Association · 2026Article
- Age but not sex modifies lymphoid immune responses in murine sepsis.Research square · 2026Article
- Blood biomarker trajectories in ICU-directed prediction models - A scoping review.The EPMA journal · 2026Review
- Association between B and T lymphocyte attenuator/herpes virus entry mediator immunoregulatory axis and outcome prediction in a mixed critically ill population.Scientific reports · 2026Article
- Multi-omics analysis reveals that ginsenoside Rb1 improves prognostic outcomes in sepsis by modulating mitochondrial metabolism MTHFD2 targets.Scientific reports · 2026Article
- A Prediction Model for Persistent Inflammation-Immunosuppression-Catabolism Syndrome in Patients with Sepsis: An Ambispective Cohort Study.Infection and drug resistance · 2026Article
- Machine learning reveals an interleukin-33-associated immuno-metabolic axis defining recovery endotypes in severe combat trauma.Frontiers in immunology · 2026Article
- Association between urea-to-creatinine ratio trajectories and clinical outcomes in chronic critical illness patients: a retrospective cohort study.Frontiers in nutrition · 2026Article
- Assessment of soluble PD-L1 in septic shock in relation to immunosuppressive phenotypes.Annals of intensive care · 2026Article
- Persistent inflammation, immunosuppression, and catabolism syndrome and sepsis in pediatric burns.Burns : journal of the International Society for Burn Injuries · 2025Article
- Systemic inflammation impairs myelopoiesis and interferon type I responses in humans.Nature immunology · 2025Article
25 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundMany sepsis survivors develop chronic critical illness (CCI) and are assumed to be immunosuppressed, but there is limited clinical evidence to support this. We sought to determine whether the incidence of secondary infections and immunosuppressive biomarker profiles of patients with CCI differ from those with rapid recovery (RAP) after sepsis.
methodsThis prospective observational study evaluated 88 critically ill patients with sepsis and 20 healthy controls. Cohorts were defined based on clinical trajectory (early death, RAP, or CCI), whereas immunosuppression was clinically determined by the presence of a postsepsis secondary infection. Serial blood samples were collected for absolute lymphocyte counts (ALCs), monocytic human leukocyte antigen-DR (mHLA-DR) expression, and plasma-soluble programmed death-ligand 1 (sPD-L1) concentrations.
resultsOf the 88 patients with sepsis, 3 (3%) died within 14 days of sepsis onset, 50 (57%) experienced RAP, and 35 (40%) developed CCI. Compared with RAP patients, CCI patients exhibited a higher incidence and overall number of infections adjusted for hospital length of stay. ALC and mHLA-DR levels were dramatically reduced at the time of sepsis diagnosis when compared with healthy controls, whereas sPD-L1 concentrations were significantly elevated. There were no differences between RAP and CCI patients in ALC, sPD-L1, or mHLA-DR at the time of diagnosis or within 24 h after sepsis diagnosis. However, in contrast to the RAP group, CCI patients failed to exhibit any trend toward restoration of normal values of ALC, HLA-DR, and sPD-L1.
conclusionsSeptic patients demonstrate clinical and biological evidence to suggest they are immunosuppressed at the time of sepsis diagnosis. Those who develop CCI have a greater incidence of secondary infections and persistently aberrant markers of impaired host immunity, although measurements at the time of sepsis onset did not distinguish between subjects with RAP and CCI.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.