Survivorship After Critical Illness and Post-Intensive Care Syndrome

Cagino, Leigh M.; Seagly, Katharine

doi:10.1016/j.ccm.2022.05.009

Cited by 8 publications

(9 citation statements)

References 100 publications

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“…These complications contribute to a lower quality-of-life, and may hamper swift return to work for patients who were employed before ICU-admission [27]. Also, late mortality of ICU-survivors is higher as compared with controls [2].…”

Section: Long-term Complications After Critical Illness and Artificia...mentioning

confidence: 99%

“…Thanks to major advances in intensive care medicine, critically ill patients nowadays can survive many insults and medical complications that only a few decades ago would unavoidably culminate in death. With the growing cohort of critical illness survivors, however, it became clear that many face (currently largely unexplained) long-term physical, mental and/or neurocognitive problems, and inherent lower quality-of-life, up to years after hospitaldischarge [1][2][3][4][5][6]. Preadmission disease could be involved [2][3][4], but also the acute insult necessitating ICU-admission and its complications, or the intensive care management itself, could induce or aggravate part of this legacy [3,6].…”

Section: Introductionmentioning

confidence: 99%

“…With the growing cohort of critical illness survivors, however, it became clear that many face (currently largely unexplained) long-term physical, mental and/or neurocognitive problems, and inherent lower quality-of-life, up to years after hospitaldischarge [1][2][3][4][5][6]. Preadmission disease could be involved [2][3][4], but also the acute insult necessitating ICU-admission and its complications, or the intensive care management itself, could induce or aggravate part of this legacy [3,6]. Artificial nutrition is one treatment-related factor with impact on short-and long-term outcomes of critical illness [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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The epigenetic legacy of ICU feeding and its consequences

Vanhorebeek

Berghe²

2023

Current Opinion in Critical Care

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Purpose of reviewMany critically ill patients face physical, mental or neurocognitive impairments up to years later, the etiology remaining largely unexplained. Aberrant epigenetic changes have been linked to abnormal development and diseases resulting from adverse environmental exposures like major stress or inadequate nutrition. Theoretically, severe stress and artificial nutritional management of critical illness thus could induce epigenetic changes explaining long-term problems. We review supporting evidence.Recent findingsEpigenetic abnormalities are found in various critical illness types, affecting DNA-methylation, histone-modification and noncoding RNAs. They at least partly arise de novo after ICU-admission. Many affect genes with functions relevant for and several associate with long-term impairments. As such, de novo DNA-methylation changes in critically ill children statistically explained part of their disturbed long-term physical/neurocognitive development. These methylation changes were in part evoked by early-parenteral-nutrition (early-PN) and statistically explained harm by early-PN on long-term neurocognitive development. Finally, long-term epigenetic abnormalities beyond hospital-discharge have been identified, affecting pathways highly relevant for long-term outcomes.SummaryEpigenetic abnormalities induced by critical illness or its nutritional management provide a plausible molecular basis for their adverse effects on long-term outcomes. Identifying treatments to further attenuate these abnormalities opens perspectives to reduce the debilitating legacy of critical illness.

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Section: Long-term Complications After Critical Illness and Artificia...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The epigenetic legacy of ICU feeding and its consequences

Vanhorebeek

Berghe²

2023

Current Opinion in Critical Care

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“…The long-term impact of nutritional management in ICU on autophagy in relation to the long-term adverse legacy after critical illness [104–110,131 ▪ ,132] remains unclear. Epigenetic abnormalities induced by critical illness or its nutritional management provide a plausible molecular basis for their adverse effects on long-term outcomes [133–136,137 ▪ ].…”

Section: Nutrition and Autophagy Deficiency In Critical Illnessmentioning

confidence: 99%

Nutrition and autophagy deficiency in critical illness

Vanhorebeek

Casaer

Gunst

2023

Current Opinion in Critical Care

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Purpose of review Critical illness imposes a severe insult on the body, with various stressors triggering pronounced cell damage. This compromises cellular function, leading to a high risk of multiple organ failure. Autophagy can remove damaged molecules and organelles but appears insufficiently activated during critical illness. This review discusses insight into the role of autophagy in critical illness and the involvement of artificial feeding in insufficient autophagy activation in critical illness. Recent findings Animal studies manipulating autophagy have shown its protective effects against kidney, lung, liver, and intestinal injury after several critical insults. Autophagy activation also protected peripheral, respiratory, and cardiac muscle function, despite aggravated muscle atrophy. Its role in acute brain injury is more equivocal. Animal and patient studies showed that artificial feeding suppressed autophagy activation in critical illness, particularly with high protein/amino acid doses. Feeding-suppressed autophagy may explain short and long-term harm by early enhanced calorie/protein feeding in large randomized controlled trials. Summary Insufficient autophagy during critical illness is at least partly explained by feeding-induced suppression. This may explain why early enhanced nutrition failed to benefit critically ill patients or even induced harm. Safe, specific activation of autophagy avoiding prolonged starvation opens perspectives for improving outcomes of critical illness.

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“…Eine Arbeit aus dem Jahr 2022 betont, dass die Erholung und Rehabilitation nach einem Intensivaufenthalt komplex sind und Nachsorgeangebote individuell auf die Betroffenen abgestimmt sein müssen 13 .…”

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PICS – Welche Nachsorge benötigen Betroffene?

Emsden,

Schütz

2023

intensiv

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Die Langzeitfolgen einer kritischen Erkrankung sind in den Fokus der Intensivstationen gerückt. Innerhalb der Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin wurde kürzlich die Sektion PICS gegründet, um sich im multiprofessionellen Austausch dem Thema zu widmen. Einen Einblick in die Nachsorge von PICS-Betroffenen geben die Autoren dieses Artikels anhand einer Literaturübersicht und eines Erfahrungsberichts von mehr als sechs Jahren in einer Post-ICU-Sprechstunde.

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Survivorship After Critical Illness and Post-Intensive Care Syndrome

Cited by 8 publications

References 100 publications

The epigenetic legacy of ICU feeding and its consequences

The epigenetic legacy of ICU feeding and its consequences

Nutrition and autophagy deficiency in critical illness

PICS – Welche Nachsorge benötigen Betroffene?

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