Title :

Chronic critical illness and post-intensive care syndrome: from pathophysiology to clinical challenges

Author(s) :

Voiriot, Guillaume [Auteur]
AP-HP. Sorbonne Université [GHU]
Oualha, Mehdi [Auteur]
Hôpital Necker - Enfants Malades [AP-HP]
Pierre, Alexandre [Auteur]
Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 [RID-AGE]
Salmon-Gandonnière, Charlotte [Auteur]
Centre Hospitalier Régional Universitaire de Tours [CHRU Tours]
Gaudet, Alexandre [Auteur]
Centre d’Etude des Pathologies Respiratoires (CEPR), UMR 1100 [CEPR]
Jouan, Youenn [Auteur]
Centre Hospitalier Régional Universitaire de Tours [CHRU Tours]
Kallel, Hatem [Auteur]
Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]
Radermacher, Peter [Auteur]
Hôpital Lariboisière-Fernand-Widal [APHP]
Vodovar, Dominique [Auteur]
Optimisation thérapeutique en Neuropsychopharmacologie [OPTeN (UMR_S 1144 / U1144)]
Sarton, Benjamine [Auteur]
Toulouse NeuroImaging Center [ToNIC]
Centre Hospitalier Universitaire de Toulouse [CHU Toulouse]
Stiel, Laure [Auteur]
Bréchot, Nicolas [Auteur]
Préau, Sébastien [Auteur]
Joffre, Jérémie [Auteur]

Journal title :

Annals of Intensive Care

Pages :

58

Publisher :

SpringerOpen

Publication date :

2022-12

ISSN :

2110-5820

English keyword(s) :

Post-ICU syndrome Chronic critical illness Long-term outcome ICU sequelae Neuromuscular disorders Cognitive impairment Acquired immunosuppression
Post-ICU syndrome
Chronic critical illness
Long-term outcome
ICU sequelae
Neuromuscular disorders
Cognitive impairment
Acquired immunosuppression

HAL domain(s) :

Sciences du Vivant [q-bio]
Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Physiologie [q-bio.TO]

English abstract : [en]

Abstract Background Post‐intensive care syndrome (PICS) encompasses physical, cognition, and mental impairments persisting after intensive care unit (ICU) discharge. Ultimately it significantly impacts the long‐term ...
Show more >Abstract Background Post‐intensive care syndrome (PICS) encompasses physical, cognition, and mental impairments persisting after intensive care unit (ICU) discharge. Ultimately it significantly impacts the long‐term prognosis, both in functional outcomes and survival. Thus, survivors often develop permanent disabilities, consume a lot of healthcare resources, and may experience prolonged suffering. This review aims to present the multiple facets of the PICS, decipher its underlying mechanisms, and highlight future research directions. Main text This review abridges the translational data underlying the multiple facets of chronic critical illness (CCI) and PICS. We focus first on ICU-acquired weakness, a syndrome characterized by impaired contractility, muscle wasting, and persisting muscle atrophy during the recovery phase, which involves anabolic resistance, impaired capacity of regeneration, mitochondrial dysfunction, and abnormalities in calcium homeostasis. Second, we discuss the clinical relevance of post-ICU cognitive impairment and neuropsychological disability, its association with delirium during the ICU stay, and the putative role of low-grade long-lasting inflammation. Third, we describe the profound and persistent qualitative and quantitative alteration of the innate and adaptive response. Fourth, we discuss the biological mechanisms of the progression from acute to chronic kidney injury, opening the field for renoprotective strategies. Fifth, we report long-lasting pulmonary consequences of ARDS and prolonged mechanical ventilation. Finally, we discuss several specificities in children, including the influence of the child’s pre-ICU condition, development, and maturation. Conclusions Recent understandings of the biological substratum of the PICS’ distinct features highlight the need to rethink our patient trajectories in the long term. A better knowledge of this syndrome and precipitating factors is necessary to develop protocols and strategies to alleviate the CCI and PICS and ultimately improve patient recovery.Show less >

Language :

Anglais

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

ANR Project :

Lipoprotéines et santé : prévention et traitement des maladies inflammatoires non vasculaires et du cancer

Collections :

• Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement (RID-AGE) - U1167

Source :

Harvested from HAL