Failure of circulating monocytes for adequate cytokine production is a trait of sepsis-induced immunosuppression; however, its duration and association with final outcome are poorly understood. Defective TNF-α production is a major trait of sepsis-induced immunosuppression. It is associated with significant risk for unfavourable outcome and persists until day 10. Cardiovascular failure on admission is predictive of defective TNF-α production during follow-up.

The present study emphasises the association between cytokine stimulation of circulating PBMCs and final outcome. Sustained decreased cytokine production is linked with great risk for unfavourable outcome, and it is a characteristic of sepsis-induced immunosuppression. Defective production of TNF-α lasts as long as day 10, and it is associated with greatest risk for unfavourable outcome. CV failure on admission is a major indicator of the likelihood for defective TNF-α responses over the time course of sepsis. These findings can help in the design of future trials on immunostimulation for the management of severe sepsis.

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