• Critical care clinics · Apr 2017

    Review

    Persistent Inflammation, Immunosuppression and Catabolism Syndrome.

    • Juan C Mira, Scott C Brakenridge, Lyle L Moldawer, and Frederick A Moore.
    • Department of Surgery, Sepsis and Critical Illness Research Center, University of Florida College of Medicine, 1600 Southwest Archer Road, PO Box 100019, Gainesville, FL 32610-0019, USA.
    • Crit Care Clin. 2017 Apr 1; 33 (2): 245-258.

    AbstractFollowing advances in critical care, in-hospital multiple organ failure-related mortality is declining. Consequently, incidence of chronic critical illness is increasing. These patients linger in the intensive care unit, have high resource utilization, and poor long-term outcomes. Within this population, the authors propose that a substantial subset of patients have a new phenotype: persistent inflammation, immunosuppression, and catabolism syndrome. There is evidence that myelodysplasia with expansion of myeloid-derived suppressor cells, innate and adaptive immune suppression, and protein catabolism with malnutrition are major contributors. Optimal care of these patients will require novel multimodality interventions.Copyright © 2016 Elsevier Inc. All rights reserved.

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