Observational studyAmerican journal of respiratory and critical care medicine2018
Early Immune Function and Duration of Organ Dysfunction in Critically III Children with Sepsis.
Observational study in American journal of respiratory and critical care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 2 of them syntheses that pooled it.
What it found
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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
49 citing papers in PubMed, 2 syntheses or guidelines pooled it, 83 citations in OpenAlex.
- Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026.Intensive care medicine · 2026Pooled it
- Immune System Dysfunction Criteria in Critically Ill Children: The PODIUM Consensus Conference.Pediatrics · 2022Pooled it
- Aberrant STAT signaling and T cell dysregulation define a targetable pediatric sepsis endotype.The Journal of clinical investigation · 2026Article
- Age-related differences and common pathways of lymphocyte subsets in sepsis: a comparative review of elderly and pediatric patients.Cell death & disease · 2026Review
- Association of peripheral blood lymphocytes and immunoglobulins with disease severity in pediatric acute respiratory distress syndrome: an age-stratified retrospective study.BMC pediatrics · 2026Article
- Pediatric Critical Illness, Immunometabolism and Cardiovascular Risk: A Narrative Review.Minerva pediatrics · 2026Article
- Pediatric Sepsis: Evolving Subphenotypes, Overlap Syndromes, and the Path to Precision Therapies.Clinics in chest medicine · 2026Review
- Bench-to-Bedside Insights into the Challenges of Immunosuppression in Sepsis.Pathogens (Basel, Switzerland) · 2026Review
- PRC1 promotes immunosuppressive macrophages in sepsis via β-catenin/STAT3 signaling.Cellular and molecular life sciences : CMLS · 2026Article
- Research Progress on Sepsis Diagnosis and Monitoring Based on Omics Technologies: A Review.Diagnostics (Basel, Switzerland) · 2025Review
- Association between the changing trends of platelet distribution width and in-hospital mortality in critically ill patients with sepsis: a multicenter study based on machine learning.BMC infectious diseases · 2025Article
- Potential biomarkers used for risk estimation of pediatric sepsis-associated organ dysfunction and immune dysregulation.Pediatric research · 2025Review
- Lipopolysaccharide (LPS)-Induced Tumor Necrosis Factor-Alpha (TNF-ɑ) Levels and Health Care Associated Infection (HAI) in Children with Multi-Organ Dysfunction Syndrome (MODS).Indian journal of pediatrics · 2025Article
- Immunomodulation in Pediatric Sepsis: A Narrative Review.Journal of clinical medicine · 2025Review
- Integrating bioinformatics and machine learning for comprehensive analysis and validation of diagnostic biomarkers and immune cell infiltration characteristics in pediatric septic shock.Scientific reports · 2025Article
- Plasma proteomics in pediatric patients with sepsis- hopes and challenges.Clinical proteomics · 2025Review
- Elevated total bile acid levels as an independent predictor of mortality in pediatric sepsis.Pediatric research · 2025Article
- Immune signatures of sepsis from mild infection to critical illness - a prospective observational study.Frontiers in immunology · 2025Observational
- Development and optimization of a diluted whole blood ELISpot assay to test immune function.Journal of immunological methods · 2024Observational
- Predicting Organ Dysfunction in Septic and Critically Ill Patients: A Prospective Cohort Study Using Rapid Ex Vivo Immune Profiling.Critical care explorations · 2024Observational
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
rationaleLate immune suppression is associated with nosocomial infection and mortality in adults and children with sepsis. Relationships between early immune suppression and outcomes in children with sepsis remain unclear.
objectivesProspective observational study to test the hypothesis that early innate and adaptive immune suppression are associated with longer duration of organ dysfunction in children with severe sepsis or septic shock.
methodsChildren younger than 18 years of age meeting consensus criteria for severe sepsis or septic shock were sampled within 48 hours of sepsis onset. Healthy control subjects were sampled once. Innate immune function was quantified by whole blood ex vivo LPS-induced TNF-α (tumor necrosis factor-α) production capacity. Adaptive immune function was quantified by ex vivo phytohemagglutinin-induced IFN-γ production capacity. MEASUREMENTS AND MAIN
resultsOne hundred two children with sepsis and 35 healthy children were enrolled. Compared with healthy children, children with sepsis demonstrated lower LPS-induced TNF-α production (P < 0.0001) and lower phytohemagglutinin-induced IFN-γ production (P < 0.0001). Among children with sepsis, early innate and adaptive immune suppression were associated with greater number of days with multiple organ dysfunction syndrome and greater number of days with any organ dysfunction. On multivariable analyses, early innate immune suppression remained independently associated with increased multiple organ dysfunction syndrome days (adjusted relative risk, 1.2; 95% confidence interval, 1.03-1.5) and organ dysfunction days (adjusted relative risk, 1.2; 95% confidence interval, 1.1-1.3).
conclusionsCritically ill children with severe sepsis or septic shock demonstrate early innate and adaptive immune suppression. Early innate and adaptive immune suppression are associated with longer durations of organ dysfunction and may be useful markers to help guide future investigations of immunomodulatory therapies in children with sepsis.
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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.