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. 2015 Apr 26;1(1):e784.
doi: 10.14800/janhm.784.

Persistent inflammatory, immunosuppressed, catabolic syndrome (PICS): A new phenotype of multiple organ failure

Martin D Rosenthal  1 , Frederick A Moore  1
Affiliations

Persistent inflammatory, immunosuppressed, catabolic syndrome (PICS): A new phenotype of multiple organ failure

Martin D Rosenthal et al. J Adv Nutr Hum Metab. .

Abstract

A new phenotype of multiple organ failure has appeared: Persistent Inflammatory, Immunosuppressed, Catabolic Syndrome (PICS). Comorbidities and age >65 years have been established as the leading risk factors for PICS. As the percentage of elderly people continues to increase the prevalence of PICS in our ICUs will surely grow. Malnutrition (despite appropriate supplementation), recurrent nosocomial infections, frailty, ventilator dependence, and an indolent death depicts the central theme that plagues PICS patients. Aligned with the recently awarded P50 grant by NIGMS entitled, "PICS: A New Horizon for Surgical Critical Care", and the University Of Florida's Sepsis and Critical Illness Research Center will investigate the genetic make-up of PICS patients, better understand frailty and the implication in trauma patients, and hopefully elucidate new therapies. Currently, there are no therapies to combat PICS aside from nutritional inference elaborated after reviewing the literature on Burns, Cachexia, and Sarcopenia.

Keywords: Catabolism; Immunosuppression; Inflammation; MOF; Multiple Organ Failure; PICS; Persistent; Syndrome; nutrition.

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Conflict of interest statement

Conflict of Interest and Financial Disclosure Statement

No conflict of or competing interests have been declared and there were no funds provided for this manuscript.

Figures

Figure 1
Figure 1. Clinical Progression to PICS
Figure 2
Figure 2. Schematic depiction of the evolution of MOF to PICS
Figure 3
Figure 3. How PICS becomes the final outcome
(MOF=Multiple Organ Failure. SIRS=Systemic Inflammatory Response Syndrome. CARS= Compensatory Anti-Inflammatory Response Syndrome. PICS= Persistent Inflammation, Immunosuppression, Catabolism Syndrome.)
See this image and copyright information in PMC

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