scholarly journals Persistent inflammation, immunosuppression and catabolism syndrome: mechanisms of sarcopenia and ways of correction

2021 ◽  
Vol 16 (7-8) ◽  
pp. 110-117
Author(s):  
S.M. Chuklin ◽  
S.S. Chuklin ◽  
G.V. Shershen
Keyword(s):  
Intensive Care ◽  
Critical Illness ◽  
Necrotizing Pancreatitis ◽  
Clinical Manifestations ◽  
Severe Trauma ◽  
Significant Loss ◽  
Mild Degree ◽  
Persistent Inflammation ◽  
Chronic Critical Illness ◽  
Severe Pathology

Due to advances in intensive care, many patients with severe pathology are discharged from intensive care units. However, prolonged mild degree inflammation persists in some patients, recovery is protracted, and chronic critical illness develops in them. In addition, persistent inflammation, immunosuppression and catabolism arise. In 2012, this condition was identified as a separate syndrome, which can be observed after severe trauma and burns, sepsis, necrotizing pancreatitis. Significant loss of muscle mass that is difficult to correct is one of the leading clinical manifestations in this case. Using literature from the MEDLINE database, modern ideas about the mechanisms of sarcopenia in the persistent inflammation, immunosuppression and catabolism syndrome and possible ways of optimal anabolic support are described.

Pediatric Chronic Critical Illness, Prolonged ICU Admissions, and Clinician Distress

2021 ◽  
Author(s):  
Alison H. Miles ◽  
Cynda H. Rushton ◽  
Brian M. Wise ◽  
Aka Moore ◽  
Renee D. Boss
Keyword(s):  
Intensive Care Unit ◽  
Content Analysis ◽  
Intensive Care ◽  
Critical Illness ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Goals Of Care ◽  
Chronic Critical Illness ◽  
Conventional Content Analysis ◽  
Clinical Interactions

AbstractTo gain an in-depth understanding of the experience of pediatric intensive care unit (PICU) clinicians caring for children with chronic critical illness (CCI), we conducted, audiotaped, and transcribed in-person interviews with PICU clinicians. We used purposive sampling to identify five PICU patients who died following long admissions, whose care generated substantial staff distress. We recruited four to six interdisciplinary clinicians per patient who had frequent clinical interactions with the patient/family for interviews. Conventional content analysis was applied to the transcripts resulting in the emergence of five themes: nonbeneficial treatment; who is driving care? Elusive goals of care, compromised personhood, and suffering. Interventions directed at increasing consensus, clarifying goals of care, developing systems allowing children with CCI to be cared for outside of the ICU, and improving communication may help to ameliorate this distress.

scholarly journals Prediction of chronic critical illness in a general intensive care unit

2013 ◽  
Vol 59 (3) ◽  
pp. 241-247 ◽  
Author(s):  
Sérgio H. Loss ◽  
Cláudia B. Marchese ◽  
Márcio M. Boniatti ◽  
Iuri C. Wawrzeniak ◽  
Roselaine P. Oliveira ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critical Illness ◽  
General Intensive Care Unit ◽  
Chronic Critical Illness

scholarly journals Pediatric Chronic Critical Illness: Protocol for a Scoping Review

10.2196/30582 ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. e30582
Author(s):  
David Zorko ◽  
James Dayre McNally ◽  
Bram Rochwerg ◽  
Neethi Pinto ◽  
Rachel Couban ◽  
...  
Keyword(s):  
Intensive Care ◽  
Critical Illness ◽  
Scoping Review ◽  
Clinical Characteristics ◽  
Case Definition ◽  
Critically Ill Children ◽  
Data Abstraction ◽  
Chronic Critical Illness ◽  
Scoping Reviews ◽  
Citation Screening

Background Improvements in the delivery of intensive care have increased survival among even the most critically ill children, thereby leading to a growing number of children with chronic complex medical conditions in the pediatric intensive care unit (PICU). Some of these children are at a significant risk of recurrent and prolonged critical illness, with higher morbidity and mortality, making them a unique population described as having chronic critical illness (CCI). To date, pediatric CCI has been understudied and lacks an accepted consensus case definition. Objective This study aims to describe the protocol and methodology used to perform a scoping review that will describe how pediatric CCI has been defined in the literature, including the concept of prolonged PICU admission and the methodologies used to develop any existing definitions. It also aims to describe patient characteristics and outcomes evaluated in the included studies. Methods We will search four electronic databases for studies that evaluated children admitted to any PICU identified with CCI. We will also search for studies describing prolonged PICU admission, as this concept is related to pediatric CCI. Furthermore, we will develop a hybrid crowdsourcing and machine learning (ML) methodology to complete citation screening. Screening and data abstraction will be performed by 2 reviewers independently and in duplicate. Data abstraction will include the details of population definitions, demographic and clinical characteristics of children with CCI, and evaluated outcomes. Results The database search, crowd reviewer recruitment, and ML algorithm development began in March 2021. Citation screening and data abstraction were completed in April 2021. Final data verification is ongoing, with analysis and results anticipated to be completed by fall 2021. Conclusions This scoping review will describe the existing or suggested definitions of pediatric CCI and important demographic and clinical characteristics of patients to whom these definitions have been applied. This review’s results will help inform the development of a consensus case definition for pediatric CCI and set a priority agenda for future research. We will use and demonstrate the validity of crowdsourcing and ML methodologies for improving the efficiency of large scoping reviews. International Registered Report Identifier (IRRID) DERR1-10.2196/30582

scholarly journals PERSISTENT METABOLOMIC ALTERATIONS CHARACTERIZE CHRONIC CRITICAL ILLNESS AFTER SEVERE TRAUMA

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Dara L. Horn ◽  
Lisa F. Bettcher ◽  
Sandi L. Navarro ◽  
Vadim Pascua ◽  
Fausto Carnevale Neto ◽  
...  
Keyword(s):  
Critical Illness ◽  
Severe Trauma ◽  
Chronic Critical Illness

Biomarker Evidence of the Persistent Inflammation, Immunosuppression and Catabolism Syndrome (PICS) in Chronic Critical Illness (CCI) after Surgical Sepsis

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Dijoia B. Darden ◽  
Scott C. Brakenridge ◽  
Philip A. Efron ◽  
Gabriela L. Ghita ◽  
Brittany P. Fenner ◽  
...  
Keyword(s):  
Critical Illness ◽  
Persistent Inflammation ◽  
Chronic Critical Illness

scholarly journals Prediction of chronic critical illness in a general intensive care unit

2013 ◽  
Vol 59 (3) ◽  
pp. 241-247
Author(s):  
Sérgio H. Loss ◽  
Cláudia B. Marchese ◽  
Márcio M. Boniatti ◽  
Iuri C. Wawrzeniak ◽  
Roselaine P. Oliveira ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critical Illness ◽  
General Intensive Care Unit ◽  
Chronic Critical Illness
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