Dataset Information

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

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.

SUBMITTER: Pei F

PROVIDER: S-EPMC9790819 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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

Pei Fei F Yao Ren-Qi RQ Ren Chao C Bahrami Soheyl S Billiar Timothy R TR Chaudry Irshad H IH Chen De-Chang DC Chen Xu-Lin XL Cui Na N Fang Xiang-Ming XM Kang Yan Y Li Wei-Qin WQ Li Wen-Xiong WX Liang Hua-Ping HP Lin Hong-Yuan HY Liu Ke-Xuan KX Lu Ben B Lu Zhong-Qiu ZQ Maegele Marc M Peng Tian-Qing TQ Shang You Y Su Lei L Sun Bing-Wei BW Wang Chang-Song CS Wang Jian J Wang Jiang-Huai JH Wang Ping P Xie Jian-Feng JF Xie Li-Xin LX Zhang Li-Na LN Zingarelli Basilia B Guan Xiang-Dong XD Wu Jian-Feng JF Yao Yong-Ming YM

Military Medical Research 20221226 1

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 ...[more]

PMID: 36567402

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Project description:Bispecific antibodies (BsAbs) are emerging as an important novel class of immunotherapeutic agents for the treatment of multiple myeloma (MM), and are set to be more widely used in clinical practice. However, this new class of therapies is associated with a distinct adverse event (AE) profile that includes cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome, as well as AEs leading to increased infection risk such as cytopenias and hypogammaglobulinemia, and infections themselves. As preliminary data with this class of agents shows an increased risk of infections as compared with conventional MM treatment regimens, such as immunomodulatory drugs, proteasome inhibitors, and anti-CD38 monoclonal antibodies (mAbs), guidance on infection monitoring, prophylaxis and treatment is required. This review provides consensus recommendations from a panel of 13 global experts, following a meeting in August 2022. The meeting objective was to review existing literature and identify relevant information on infections with all BsAbs in patients with MM, as well as to discuss clinical experience of experts in managing these infections. The recommendations outlined here can be used to guide management of infection risk factors, such as hypogammaglobulinemia and neutropenia. In addition, they can be used to guide the monitoring, prophylaxis, and treatment of bacterial, viral and fungal infections, including emerging infections of interest, such as coronavirus 2019 (COVID-19), and the use of vaccinations prior to and during BsAb treatment. The recommendations have been graded by the panel based on level of data available. Key recommendations include universal herpes simplex and varicella zoster virus prophylaxis, screening for hepatitis B virus reactivation risk in all patients, monthly intravenous immunoglobulin treatment for immunoparesis and in the absence of life-threatening infectious manifestations, use of colony-stimulating factors in patients with Grade 3 neutropenia, universal pneumocystis jirovecii pneumonia prophylaxis and no routine anti-fungal prophylaxis.

Dataset Information

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

Publications

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

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