ArticleNutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition2017
Nutrition Support for Persistent Inflammation, Immunosuppression, and Catabolism Syndrome.
Article in Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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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.
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Who cites it
28 citing papers in PubMed, 74 citations in OpenAlex.
- A Prediction Model for Persistent Inflammation-Immunosuppression-Catabolism Syndrome in Patients with Sepsis: An Ambispective Cohort Study.Infection and drug resistance · 2026Article
- Persistent inflammation, immunosuppression, and catabolism syndrome and sepsis in pediatric burns.Burns : journal of the International Society for Burn Injuries · 2025Article
- A New Perspective on Overfeeding in the Intensive Care Unit (ICU): Challenges, Dangers and Prevention Methods.Life (Basel, Switzerland) · 2025Review
- Association Between Malnutrition and Multi-Drug Resistant Bacterial Infections in Neurosurgical Intensive Care Unit Patients.Infection and drug resistance · 2025Article
- Challenges in Metabolite Biomarkers as Avenues of Diagnosis and Prognosis of Cancer.Journal of cancer prevention · 2024Article
- Nutritional and metabolic modulation of inflammation in critically ill patients: a narrative review of rationale, evidence and grey areas.Annals of intensive care · 2024Review
- Japanese Clinical Practice Guidelines for Rehabilitation in Critically Ill Patients 2023 (J-ReCIP 2023).Journal of intensive care · 2023Review
- Clinical treatment for persistent inflammation, immunosuppression and catabolism syndrome in patients with severe acute pancreatitis (Review).Experimental and therapeutic medicine · 2023Review
- Effects of Antithrombin on Persistent Inflammation, Immunosuppression, and Catabolism Syndrome among Patients with Sepsis-Induced Disseminated Intravascular Coagulation.Journal of clinical medicine · 2023Article
- Development and validation of prediction scores for the outcome associated with persistent inflammation, immunosuppression, and catabolism syndrome among patients with trauma.Trauma surgery & acute care open · 2023Article
- Effect of blended protein nutritional support on reducing burn-induced inflammation and organ injury.Nutrition research and practice · 2022Article
- Characterization of Purified Mulberry Leaf Glycoprotein and Its Immunoregulatory Effect on Cyclophosphamide-Treated Mice.Foods (Basel, Switzerland) · 2022Article
- Depleting Ly6G Positive Myeloid Cells Reduces Pancreatic Cancer-Induced Skeletal Muscle Atrophy.Cells · 2022Article
- Exudative glutamine losses contribute to high needs after burn injury.JPEN. Journal of parenteral and enteral nutrition · 2022Article
- Identifying cues of distorted memories in intensive care by focus group interview of nurses.Nursing open · 2022Article
- Energy expenditure and indirect calorimetry in critical illness and convalescence: current evidence and practical considerations.Journal of intensive care · 2021Review
- Metabolism of Proteins and Amino Acids in Critical Illness: From Physiological Alterations to Relevant Clinical Practice.Journal of multidisciplinary healthcare · 2021Review
- The relationship between the degree of malnutrition and changes in selected parameters of the immune response in critically ill patients.Central-European journal of immunology · 2021Article
- How to Increase Muscle Mass in Critically Ill Patients: Lessons Learned from Athletes and Bodybuilders.Current nutrition reports · 2020Review
- Disseminated Intravascular Coagulopathy Is Associated with the Outcome of Persistent Inflammation, Immunosuppression and Catabolism Syndrome.Journal of clinical medicine · 2020Article
Corrections and comments
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Authors and funding
5 authors at 5 institutions in 2 countries.
Funding
Abstract
Despite tremendous advances in critical care, multiple-organ failure continues to be a significant problem. However, in recent years, far fewer patients with multiple-organ failure die early, but many experience ongoing immune dysregulation and are developing persistent inflammation, immunosuppression, and catabolism syndrome (PICS). Most PICS patients are discharged to nonhome destinations, fail to rehabilitate, and succumb to indolent death. From a nutrition perspective, patients with PICS experience persistent inflammation-induced cachexia despite evidenced-based recommended intensive care unit nutrition support. Recent basic and translational research indicates that prolonged expansion of myeloid-derived suppressor cells plays a central role in the pathogenesis of PICS. Myeloid-derived suppressor cells express arginase 1, which depletes arginine, causing immunosuppression and impaired wound healing. This is the rationale for arginine supplementation in PICS. Other nutrition support recommendations for PICS are based on inferences made from other patient populations who experience similar persistent inflammation-induced cachexia. These include patients with established cancers, major burns, and sarcopenia. These patients experience anabolic resistance, but studies show that this can be overcome by providing higher levels of protein and certain specific amino acids. Nutrition support guidelines recommend provision of >1.5 g/kg/d of protein and indicate that higher levels may be needed. Protein composition is also important. There is good evidence that leucine can promote anabolism in patients with cancer and sarcopenia. Finally, anabolic interventions-including intensive insulin, oxandrolone, propranolol, and resistance exercise-have proven to be effective in patients with major burns and are likely relevant in combating PICS cachexia.
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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.