This study reveals several limitations. First of all, it is a retrospective subgroup analysis. Second, study drugs were administered only for a maximum of consecutive 3 days. The effect of longer duration of therapy on monocytes and immunity is unclear. Third, we analyzed only a small sample size of 10 patients in each group. Hence, some results might possibly be not significant but show a tendency. Fourth, we analyzed patients only until pod5. The impact of GM-CSF application on immune function after this time is unclear. Finally, the threshold level for mHLA-DR (we had ≤ 10,000 mAb/cell) used to stratify patients with severe surgery-induced immunosuppression is unclear. Studies suggest that values between 5,000 and 10,000 mAb/cell are an indicator of severely impaired immune function in critically ill patients [7, 11, 21]..
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