Santarelli Michael D, Davis Kelly A, Stark Ryan J
Department of Pediatrics, Pediatric Critical Care Medicine, Vanderbilt University Medical Center, United States.
School of Nursing, Vanderbilt University, United States.
Curr Pediatr Rev. 2024 May 14. doi: 10.2174/0115733963298459240508050319.
Surviving near-lethal insults, such as sepsis, trauma, and major surgery is more common due to advances in medical care. The decline in mortality has unmasked a population of chronic critically ill patients, many with the pathological immunophenotype known as Persistent inflammation, Immunosuppression, and Catabolism Syndrome (PICS). Though initially described in adults, many critically ill children exhibit the hallmarks of PICS, including lymphopenia, hyperinflammation, and evidence of ongoing somatic protein catabolism. These patients are plagued with recurrent infections and suffer worse outcomes. There remains a need to understand the pathophysiology underlying this condition to elucidate potential therapies and develop interventions. This perspective provides the most current update of PICS within the pediatric population.
由于医疗护理的进步，在诸如脓毒症、创伤和大手术等近乎致命的损伤中存活下来的情况更为常见。死亡率的下降揭示了一群慢性危重症患者，其中许多人具有被称为持续性炎症、免疫抑制和分解代谢综合征（PICS）的病理免疫表型。尽管最初是在成人中描述的，但许多危重症儿童也表现出PICS的特征，包括淋巴细胞减少、炎症反应过度以及持续的体细胞蛋白分解代谢的证据。这些患者反复感染，预后更差。仍有必要了解这种疾病的病理生理学，以阐明潜在的治疗方法并制定干预措施。这一观点提供了儿科人群中PICS的最新情况。
