Preview

Military Medicine

Advanced search

Intensive care outcomes syndrome (review)

https://doi.org/10.51922/2074-5044.2025.4.79

Abstract

The syndrome of consequences of intensive care (PICS-CCI) occurs in those patients of intensive care units who survived a critical condition, if the duration of treatment in such units exceeded more than 14 days and was accompanied by organ dysfunction. It should be noted that in addition to extremely low rates of long-term rehabilitation, they also have significantly reduced physical functions associated with health, compared with other patients.

Objective: to analyze the data of literary sources touching upon the issues of such chronic critical conditions as the syndrome of consequences of intensive care; to emphasize the need for further multidisciplinary approach in the study of this phenomenon, as well as in the management and treatment of this category of patients, which will contribute to an increase in the percentage of survival and improve the quality of life of patients with PICS-CCI.

About the Authors

A. M. Dzyadzko
State Institution «Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology»
Belarus


N. I. Lendin
State Institution «Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology»
Belarus


V. V. Nesterov
State Institution «Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology»
Belarus


D. D. Nesterova
State Institution «Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology»
Belarus


A. G. Kadushkin
Educational Institution «Belarusian State Medical University»
Belarus


S. N. Shubina
Educational Institution «Belarusian State Medical University»
Belarus


References

1. Parfyonov, A. L. Hronicheskoe kriticheskoe zabolevanie: sovremennye aspekty problemy (obzor) / A. L. Parfyonov, V. P. Razzhivin, M. V. Petrova // STM. 2022. T. 14, № 3. S. 70–83.

2. Rosenthal, M. D. Chronic Critical illness and PICS Nutritional Strategies / M. D. Rosenthal, E. L. Vanzant, F. A. Moore // Journal of Clinical Medicine. 2021. № 10. Mode of access: https://doi.org/10.3390/jcm10112294. Date of access: 10.04.2025.

3. Rosenthal, M. D. Persistent, Immunosup pression, Inflammation, Catabolism Syndrome and Diaphragmatic Dysfunction / M. D. Rosenthal [et al.] // Current Pulmonology Reports. 2017. № 6. P. 54–57.

4. Hawkins, R. B. Chronic Critical Illness and the Persistent Inflammation, Immunosuppression, and Catabolism Syndrome / R. B. Hawkins [et al.] // Frontiers in Immunology. 2018. № 9. Mode of access: https://doi/10.3389/fimmu.2018.01511. Date of access: 10.04.2025.

5. Horn, D. L. Persistent metabolomic alterations characterize chronic critical illness after severe trauma / D. L. Horn [et al.] // Journal of Trauma and Acute Care Surgery. 2021. Vol. 90, № 1. P. 35–45.

6. Rosenthal, M. D. Chronic Critical Illness Patients Fail to Respond to Current Evidence-Based Intensive Care Nutrition Secondarily to Persistent Inflammation, Immunosuppression, and Catabolic Syndrome / M. D. Rosenthal [et al.] // JPEN. 2020. Vol. 44, № 7. P. 1237–1249.

7. Mikkelsen, M. E. Post-intensive care syndrome (PICS) in adults: Clinical features and diagnostic evaluation [Electronic resource] / M. E. Mikkelsen, G. Netzer, T. Iwashyna // UpToDate. Mode of access: https://www.uptodate.com/contents/post-intensive-care-syndrome-pics-in-adults-clinical-featuresand-diagnostic-evaluation/print. Date of access: 10.04.2025.

8. Marra, A. Cooccurrence of Post-Intensive Care Syndrome Problems Among 406 Survivors of Critical illness / A. Marra [et al.] // Critical Care Medicine. 2018. Vol. 46, № 9. P. 1393–1401.

9. Belkin, A. A. Sindrom posledstvij intensivnoj terapii (PIT-sindrom) / A. A. Belkin // Vestnik intensivnoj terapii imeni A. I. Saltanova. 2018. № 2. S. 12–23.

10. Marshall, J. C. Critical illness is an iatrogenic disorder / J. C. Marshall // Critical Care Medicine. 2010. Vol. 38, № 10. P. 582–589.

11. Andrejchenko, S. A. Sindrom priobretennoj v ORIT slabosti u bol’nyh s dyhatel’noj nedostatochnost’yu / S. A. Andrejchenko [i dr.] // Klinicheskaya praktika. 2021. T. 12, № 2. S. 5–13.

12. Mankowski R. T. Pathophysiology and Treatment Strategies of Acute Myopathy and Muscle Wasting after Sepsis / R. T. Mankowski [et al.] // Journal of Clinical Medicine. 2021. Mode of access: https://doi.org/10.3390/jcm10091874. Date of access 10.04.2025.

13. He, X. Post intensive care syndrome: A review of clinical symptoms, evaluation, intervention / X. He [et al.] // Heliyon. 2024. № 10. Mode of access: https://doi.org/10.1016/j.heliyon.2024. e31278. Date of access: 10.04.2025.

14. Plotnikov, G. P. Polinejromiopatiya kriticheskih sostoyanij (obzor literatury) / G. P. Plotnikov [i dr.] // Vestnik anesteziologii i reanimatologii. 2023. T. 20, № 5. S. 76–83.

15. Panahi, A. The Prevalence and Outcome of Intensive Care Unit Acquired Weakness (ICUAW) / A. Panahi [et al.] // Tanaffos. 2020. Vol. 19, № 3. P. 250–255.

16. Belkin, A. A. , Alasheev, A. M. Correlation links between the length of peripheral nerves and the rate of their involvement into critical illness polyneuropathy (CIMP) / A. A. Belkin, A. M. Alasheev // European Journal of Anesthesiology. 2005. № 22. P. 15–16.

17. Stevens, R. D. A framework for diagnosing and classifying intensive care unit-acquired weakness / R. D. Stevens [et al.] // Critical Care Medicine. 2009. Vol. 37, № 10. P. 299–308.

18. Vollenweider, R. Passive motion of the lower extremities in sedated and ventilated patients in the ICU a systematic review of early effects and replicability of Interventions / R. Vollenweider [et al.] // PLoS One. 2022. Vol. 17, № 5. Mode of access https://doi/10.1371/journal.pone.0267255. Date of access: 10.04.2025.

19. Liu, Y. The role of NLRP3 inflammasome in inflammation-related skeletal muscle atrophy / Y. Liu [et al.] // Frontiers in Immunology. 2022. Vol. 13. Mode of access: https://doi/10.3389/fimmu.2022.1035709. Date of access: 10.04.2025.

20. Latronico, N. The ICM research agenda on intensive care unit-acquired weakness / N. Latronico [et al.] // Intensive Care Medicine. 2017. Vol. 43, № 9. P. 1270–1281.

21. Brodsky, M. B. Recovery of Dysphagia Symptoms after Oral Endotracheal Intubation in ARDS Survivors: A 5-Year Longitudinal Study / M. B. Brodsky [et al] // Annals of the American Thoracic Society. 2017. Vol.14, № 3. P. 376–383.

22. Lynch, Y. T. The accuracy of the bed side swallowing evaluation for detecting aspiration in survivors of acute respiratory failure / Y. T. Lynch [et al.] // Journal of Critical Care. 2017. № 39. P. 143–148.

23. Kim, M. J. Associations between prolonged intubation and developing post-extubation dysphagia and aspiration pneumonia in non-neurologic critically ill patients / M. J. Kim [et al.] // Annals of Rehabilitation Medicine. 2015. Vol. 39, № 5. P. 763–771.

24. Malandraki, G. A. Postextubation Dysphagia in Critical Patients: A First Report from the Largest Step-Down Intensive Care Unit in Greece / G. A. Malandraki [et al.] // American Journal of Speech-Language Pathology. 2016. Vol. 25, № 2. P. 150–156.

25. Inoue, S. Post-intensive care syndrome: its pathophysiology, prevention, and future directions / S. Inoue [et al.] // Acute Medicine & Surgery. 2019. № 6. P. 233–246.

26. Sakusic, A. Potentially Modifiable Risk Factors for Long-Term Cognitive Impairment After Criti cal Illness: A Systematic Review / A. Sakusic [et al.] // Mayo Clinic Proceedings. 2018. Vol. 93, № 1. P. 68–82.

27. Kim, I-Y. The anabolic response to a meal containing different amounts of protein is not limited by the maximal stimulation of protein synthesis in healthy young adults / I-Y. Kim [et al.] // American journal of physiology. Endocrinology and metabolism. –2016. № 310. P. 73–80.

28. Landi, F. Muscle loss: the new malnutrition challenge in clinical practice / F. Landi [et al] // American journal of Clinical Nutrition. 2019. Vol. 38, № 5. P. 2113–2120.

29. McClave, S. A. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A. S.P. E.N.) / S. A. McClave [et al.] // JPEN. 2016. № 40. P. 159–211.

30. Deutz, N. E ., Wolfe, R. R. Is there a maximal anabolic response to protein intake with a meal? / N. E. Deutz, R. R. Wolfe // American journal of Clinical Nutrition. 2013. № 32. P. 309–313.

31. Hurt, R. T. Summary Points and Consensus Recommendations from the International Protein Summit / R. T. Hurt [et al.] // Nutrition in Clinical Practice. 2017. № 32. P. 142–151.

32. Jones, C. Improving rehabilitation after critical illness through outpatient physiotherapy classes and essential amino acid supplement: a randomized controlled trial / C. Jones [et al.] // Journal of Critical Care. 2015. № 30. P. 901–907.

33. Dijoia, B. D. Dysregulated Immunity and Immunotherapy after Sepsis / B. D. Dijoia [et al.] // Journal of Clinical Medicine. 2021. Vol. 10, № 8. Mode of access: https://doi.org/10.3390/jcm10081742. Date of access: 10.04.2025.

34. Lillian, H. Persistent Inflammation, Immunosuppression and Catabolism Syndrome (PICS) after Polytrauma: A Rare Syndrome with Major Consequences / H. Lillian [et al.] // Journal of Clinical Medicine. 2020. Vol.9, № 1. Mode of access: https://doi.org/10.3390/jcm9010191. Date of access: 10.04.2025.

35. Hiroyuki, H. Innate Immunity in the Persistent Inflammation, Immunosuppression, and Catabolism Syndrome and Its Implications for Therapy / H. Hiroyuki [et al.] // Frontiers in Immunology. 2018. № 9. Mode of access: https://doi.org/10.3389/fimmu.2018.00595. Date of access: 10.04.2025.

36. Rosenthal, M. D. Chronic critical illness: application of what we know / M. D. Rosenthal [et al.] // Nutrition in Clinical Practice.2018. № 33. P. 39–45.

37. Rivera, A. Innate cell communication kickstarts pathogen-specific immunity / A. Rivera [et al.] // Nature Immunology. 2016. № 17. P. 356–363.

38. Fleshner, M ., Crane, C. R. Exosomes, DAMPs and miRNA: Features of stress physiology and immune homeostasis / M. Fleshner, C. R. Crane // Trends Immunology. –2017. № 38. P. 768–776.

39. Kang, J-W. DAMPs activating innate immune responses in sepsis / J-W. Kang [et al.] // Ageing Research Reviews. 2015. № 24. P. 54–65.

40. Maslanik, T. The inflammasome and danger associated molecular patterns (DAMPs) are implicated in cytokine and chemokine responses following stressor exposure / T. Maslanik [et al.] // Brain, Behavior and Immunity. 2013. № 28. P. 54–62.

41. Fleshner, M. Stress-evoked sterile inflammation, danger associated molecular patterns (DAMPs), microbial associated molecular patterns (MAMPs) and the inflammasome / M. Fleshner // Brain, Behavior and Immunity. 2013. № 27. P. 1–7.

42. Hu, Q. Elevated levels of plasma mitochondrial DNA are associated with clinical outcome in intraabdominal infections caused by severe trauma / Q. Hu [et al.] // Surgery Infection. 2017. № 18. P. 610–618.

43. Timmermans, K. Plasma nuclear and mitochondrial DNA levels, and markers of inflammation, shock, and organ damage in patients with septic shock / K. Timmermans[et al.] // Shock. 2016. № 45. P. 607–612.

44. Ingels, C. Soluble RAGE and the RAGE ligands HMGB1 and S100A12 in critical illness: Impact of glycemic control with insulin and relation with clinical outcome / C. Ingels [et al.] // Shock. 2015. № 43. P. 109–116.

45. Achouiti, A. S100A12 and soluble receptor for advanced glycation end products levels during human severe sepsis / A. Achouiti [et al.] // Shock. 2013. № 40. P. 188–194.

46. Picca, A. Circulating Mitochondrial DNA at the Crossroads of Mitochondrial Dysfunction and Inflammation During Aging and Muscle Wasting Disorders / A. Picca [et al.] // REJUVENATION RESEARCH. 2018. Vol. 21, № 4. P. 350–359.

47. Mira, J. C. Sepsis pathophysiology, chronic critical illness, and persistent inflammation-immunosuppression and catabolism syndrome / J. C. Mira [et al.] // Critical Care Medicine. 2017. № 45. P. 253–262.


Review

For citations:


Dzyadzko A.M., Lendin N.I., Nesterov V.V., Nesterova D.D., Kadushkin A.G., Shubina S.N. Intensive care outcomes syndrome (review). Military Medicine. 2025;(4):79-89. (In Russ.) https://doi.org/10.51922/2074-5044.2025.4.79

Views: 141

JATS XML


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2074-5044 (Print)