PATHOPHYSIOLOGY OF PERSISTENT INFLAMMATION, IMMUNOSUPPRESSION AND CATABOLISM SYNDROME
(LITERATURE REVIEW)
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i2.11300Keywords:
chronic critical illness, inflammation, immunosuppression, catabolismAbstract
Due to advances in intensive care, the survival rate of critically ill patients has improved dramatically. Currently, many patients are discharged from intensive care units. However, in some of these patients a chronic critical illness develops, which is characterized by persistent low-grade inflammation, depression of immunity and muscle wasting. In 2012, this condition was described as a persistent inflammation, immunosuppression and catabolism syndrome, which can occur after severe trauma and burns, sepsis, necrotizing pancreatitis.
The aim – to define modern views on the mechanisms of development of persistent inflammation, immunosuppression and catabolism syndrome.
Material and Methods. The search for literature sources was carried out on the basis of MEDLINE.
Results. Expansion of myeloid-derived suppressor cells, deregulation in innate and adaptive immunity, the development of sarcopenia are the main pathophysiological mechanisms of chronic critical illness after severe inflammatory processes.
Conclusion. The persistent inflammation, immunosuppression, and catabolism syndrome provides an explanation of the underlying pathophysiological mechanisms in chronic critical illness. This is the basis for determining pathogenetically targeted treatment, which should be multimodal and focus on interrupting the inflammation/immunosuppression cycle.
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