ReviewThe journal of trauma and acute care surgery2012
Persistent inflammation and immunosuppression: a common syndrome and new horizon for surgical intensive care.
Review in The journal of trauma and acute care surgery, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 449 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Use of Microfluidics and Transcriptomics to Implement Precision Medicine in Post Solid Organ Transplant Patients
Prospective Incidence of Persistent Inflammatory, Immunosuppressed, Catabolic Syndrome in the Critically Ill Pediatric Population
Who cites it
449 citing papers in PubMed, 5 syntheses or guidelines pooled it, 757 citations in OpenAlex.
- Prognostic value of the prognostic nutritional index in sepsis, pneumonia, and tuberculosis: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
- Risk factors, biomarkers, and mechanisms for persistent inflammation, immunosuppression, and catabolism syndrome (PICS): a systematic review and meta-analysis.British journal of anaesthesia · 2024Pooled it
- Consensus-defined sarcopenia predicts adverse outcomes after elective abdominal surgery: meta-analysis.BJS open · 2023Pooled it
- Revealing the biological mechanism of acupuncture in alleviating excessive inflammatory responses and organ damage in sepsis: a systematic review.Frontiers in immunology · 2023Pooled it
- Effect of sarcopenia on survival in patients after pancreatic surgery: a systematic review and meta-analysis.Frontiers in nutrition · 2023Pooled it
- Remote Multicomponent Rehabilitation and Cost-Effectiveness in Survivors of Critical Illness.JAMA network open · 2026Trial
- Persistent immune, coagulation and cardiac dysregulation are correlated with later post-discharge mortality in children with severe malnutrition.BMC medicine · 2026Trial
- Improvement of inflammatory response and gastrointestinal function in perioperative of cholelithiasis by Modified Xiao-Cheng-Qi decoction.World journal of clinical cases · 2023Trial
- Persistent inflammation, immunosuppression, and catabolism syndrome: from conceptual framework to biological endotype.Intensive care medicine · 2026Article
- Temporal Discordance of the Inflammation, Catabolism and Immunosuppression Triad in Chronic Critical Illness.Medicina (Kaunas, Lithuania) · 2026Article
- Hallmarks of the multidimensional immune response to trauma in humans.Nature immunology · 2026Review
- Persistent inflammation, immunosuppression, and catabolism are associated with impaired lymphocytic mitochondrial metabolism during the early phase of sepsis. A single-center, prospective cohort study.Anaesthesiology intensive therapy · 2026Article
- Cellular and Molecular Mechanisms of Hemorrhagic Shock: Biological Rationale for Individualized Fluid Resuscitation Strategies and Multimodal Monitoring.Biomedicines · 2026Review
- Timing of disseminated intravascular coagulation onset is associated with development of persistent inflammation, immunosuppression, and catabolism syndrome in critically ill patients.Thrombosis journal · 2026Article
- Persistent Inflammation, Immunosuppression, and Catabolism Syndrome and Serious Infections in Burn-Injured Adults: A Retrospective Single-Center Study from 1997 to 2023.Journal of burn care & research : official publication of the American Burn Association · 2026Article
- Diffuse alveolar damage, acute respiratory distress syndrome (ARDS), and non-cardiogenic pulmonary edema (NCPE). Part 2: NCPE apart from ARDS, molecular and cellular consequences of primary injury to the lung interstitium, with comparative immunology of the dog and cat.Journal of veterinary diagnostic investigation : official publication of the American Association of Veterinary Laboratory Diagnosticians, Inc · 2026Review
- Diffuse alveolar damage, acute respiratory distress syndrome (ARDS), and non-cardiogenic pulmonary edema. Part 1: ARDS endotypes, including systemic inflammatory response syndrome and sepsis, with dog and cat examples.Journal of veterinary diagnostic investigation : official publication of the American Association of Veterinary Laboratory Diagnosticians, Inc · 2026Review
- Host-directed immune therapies: a second front in the battle against sepsis.The Journal of clinical investigation · 2026Review
- Post-Surgical Remodeling of Circulating Monocytes Identifies CD86 Expression on Non-Classical Monocytes as a Prognostic Indicator in Pancreatic Ductal Adenocarcinoma.International journal of molecular sciences · 2026Article
- Targeting Immune Dysregulation After Burn Injury for Improved Healing and Outcomes.Biomolecules · 2026Review
389 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
Surgical intensive care unit (ICU) stay of longer than 10 days is often described by the experienced intensivist as a "complicated clinical course" and is frequently attributed to persistent immune dysfunction. "Systemic inflammatory response syndrome" (SIRS) followed by "compensatory anti-inflammatory response syndrome" (CARS) is a conceptual framework to explain the immunologic trajectory that ICU patients with severe sepsis, trauma, or emergency surgery for abdominal infection often traverse, but the causes, mechanisms, and reasons for persistent immune dysfunction remain unexplained. Often involving multiple-organ failure (MOF) and death, improvements in surgical intensive care have altered its incidence, phenotype, and frequency and have increased the number of patients who survive initial sepsis or surgical events and progress to a persistent inflammation, immunosuppression, and catabolism syndrome (PICS). Often observed, but rarely reversible, these patients may survive to transfer to a long-term care facility only to return to the ICU, but rarely to self-sufficiency. We propose that PICS is the dominant pathophysiology and phenotype that has replaced late MOF and prolongs surgical ICU stay, usually with poor outcome. This review details the evolving epidemiology of MOF, the clinical presentation of PICS, and our understanding of how persistent inflammation and immunosuppression define the pathobiology of prolonged intensive care. Therapy for PICS will involve innovative interventions for immune system rebalance and nutritional support to regain physical function and well-being.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.