Current opinion in pediatrics
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This review is being published to update the literature on the function of the adaptive immune system in critical illness, specifically sepsis and acute lung injury. We have focused on the role of T cells in these syndromes. ⋯ Immunoparalysis of the adaptive immune system occurs in sepsis and acute lung injury, and is critical to the outcome. Blocking the inhibited pathways and immunostimulant cytokines improved lymphocyte function and outcome. Many such blocking agents are already effective for other diseases and could be used for immunoparalysis. Unfortunately, there is no diagnostic marker yet. In order to provide the right therapy at the right time, advancements in immunomonitoring are necessary.