Persistent Inflammation, Immunosuppression, and Catabolism Syndrome in Sepsis

Abstract

Sepsis is a life-threatening organ dysfunction resulting from a dysregulated host response to infection. Early recognition and appropriate management improve in-hospital mortality in patients with sepsis. However, many patients progress to chronic critical illness (CCI). Persistent inflammation, immunosuppression, and catabolic syndrome (PICS), a new phenotype of CCI, is characterized by chronic low-grade inflammation, host immunosuppression, and catabolic-dominant weight loss. Due to the complexity of the pathophysiologic mechanisms of PICS, there is no effective treatment available. The aim of this review is to increase understanding of the pathophysiological mechanisms of PICS in sepsis, to summarize the diagnostic criteria and potential treatments for PICS, and to help clinicians adopt more comprehensive measures to improve the long-term prognosis of patients with PICS.