Цель

rmt

Общая реаниматология

General Reanimatology

1813-97792411-7110

FSBI "SRIGR" RAMS

10.15360/1813-9779-2026-3-2678

rmt-2678

Research Article

ОБЗОРЫ И КРАТКИЕ СООБЩЕНИЯ

REVIEWS & SHORT COMMUNICATIONS

Хроническое критическое состояние: определение, эпидемиология, патогенез и клинические проявления (краткий обзор)

Chronic Critical Illness: Definition, Epidemiology, Pathogenesis, and Clinical Manifestations (Brief Review)

https://orcid.org/0000-0001-7222-9224

Довбыш

Н. Ю.

Dovbysh

N. Yu.

Николай Юрьевич Довбыш

660022, Красноярский край, г. Красноярск, ул. Партизана Железняка, д. 1; 660022, Красноярский край, г. Красноярск, ул. Партизана Железняка, д. 3а

Nikolay Yu. Dovbysh

1 Partizana Zheleznyaka Str., 660022 Krasnoyarsk, Krasnoyarsk area; 3a Partizana Zheleznyaka Str., 660022 Krasnoyarsk, Krasnoyarsk area

https://orcid.org/0000-0002-0500-2887

Грицан

А. И.

Gritsan

A. I.

Грицан Алексей Иванович

Alexey I. Gritsan

1 Partizana Zheleznyaka Str., 660022 Krasnoyarsk, Krasnoyarsk area; 3a Partizana Zheleznyaka Str., 660022 Krasnoyarsk, Krasnoyarsk area

gritsan67@mail.ru

https://orcid.org/0009-0004-0691-6623

Чеверкова

А. С.

Cheverkova

A. S.

Анна Сергеевна Чеверкова

Anna S. Cheverkova

1 Partizana Zheleznyaka Str., 660022 Krasnoyarsk, Krasnoyarsk area; 3a Partizana Zheleznyaka Str., 660022 Krasnoyarsk, Krasnoyarsk area

Красноярский государственный медицинский университет им. проф. В. Ф. Войно-Ясенецкого Минздрава России; Красноярская краевая клиническая больницаРоссияProf. V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of Russia; Krasnoyarsk Regional Clinical HospitalRussian Federation

2026

26062026

2235566

2026

Довбыш Н.Ю., Грицан А.И., Чеверкова А.С.

Dovbysh N.Y., Gritsan A.I., Cheverkova A.S.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.reanimatology.com/rmt/article/view/2678

Сочетание синдромов и проявлений органной недостаточности, развивающихся после острого критического состояния (ОКС) и детерминирующих продолжение интенсивной терапии, не имеет на данный момент единого определения. В то же время, постоянный стойкий рост числа пациентов с подобными проявлениями представляет вызов всей системе здравоохранения. Сложный патогенез, различие субтипов хронического критического заболевания (ХКЗ) обусловливают индивидуализированный подход к терапии таких пациентов.

Цель

Цель. Уточнить имеющиеся сведения о терминологии ХКЗ, его распространенности, сроках развития, клинических проявлениях, патогенезе, субтипах и вариантах исходов.

Материал и методы

Материал и методы. Провели анализ научной литературы с использованием баз данных PubMed, ScholarGoogle и eLibrary. В обзор включили 60 источников, отражающих подходы к определению ХКЗ, терминологии, изучению патогенеза, клиники и субтипов ХКЗ.

Результаты

Результаты. Выявили несколько терминов для определения ХКЗ, что отражает отношение к данному состоянию — либо как к одному из периодов ОКС, либо как к новому патологическому состоянию. Также установили 2 основных подхода к постановке диагноза ХКЗ: первый — по длительности нахождения пациента в отделении реанимации и интенсивной терапии (ОРИТ) вследствие необходимости проведения интенсивной терапии, и второй — по развитию вновь обнаруженных специфических клинико-лабораторных проявлений. Развитие ХКЗ является неблагоприятным вариантом исхода ОКС, приводя к повышению инвалидизации пациентов и росту летальности.

Заключение

Заключение. Требуется дальнейшее изучение вопроса формирования ХКЗ с установлением единых подходов к его определению, оценкой факторов риска, выделением субтипов развития и характерных органных нарушений.

The combination of syndromes and organ failure manifestations that develop after an acute critical illness (ACI) and demand the continuation of intensive care does not currently have a single definition. Meanwhile, the steadily increasing number of patients with such manifestations poses a challenge to the entire healthcare system. The complex pathogenesis and the differences in subtypes of chronic critical illness (CCI) necessitate a personalized approach to management of these patients.

Objective

Objective. To clarify the available data on the terminology of CCI, its prevalence, development timelines, clinical manifestations, pathogenesis, subtypes, and outcomes.

Materials and Methods

Materials and Methods. A literature review wasconducted using the PubMed, Google Scholar, and eLibrary databases. The review included 60 papers covering approaches to CCI definition, associated terminology, the investigation on of pathogenesis, clinical aspects, and CCI subtypes.

Results

Results. Several case definitions were identified for CCI, reflecting the attitude toward this condition — either as one of the phases of acute critical illness or as a new disease. Additionally, two main approaches to diagnosing CCI were established: the first based on the duration of patient's stay in post-anesthesia care and intensive therapy (PACU/ICU) due to the need for intensive care, and the second based on the emergence of newly identified specific clinical and laboratory manifestations. The development of CCI is an unfavorable outcome of acute critical illness, leading to increased patient disability and a rise in mortality.

Conclusion

Conclusion. Further research is needed for deeper insights into development of CCI, establishing unified approaches to its definition, assessing risk factors, identifying its subtypes and associated organ dysfunctions.

хроническое критическое заболеваниехроническое критическое состояниеэпидемиологияпатогенезсубтипы

chronic critical illnesschronic critical conditionepidemiologypathogenesissubtypes

References1

Cox J.M. Prolonged pediatric ventilatory assistance and related problems. Crit Care Med. 1973; 1 (3): 158–167. DOI: 10.1097/00003246-197305000-00011. PMID: 4585444.

Girard K., Raffin T.A. The chronically critically ill: to save or let die? Respir Care. 1985; 30 (5): 339–347. PMID: 10315661.

Tagge G.F. Linacre Q. 1975; 42 (2): 99–104. PMID: 11661177.

Indihar F.J., Forsberg D.P. Experience with a prolonged respiratory care unit. Chest. 1982; 81 (2): 189–192. DOI: 10.1378/chest.81.2.189. PMID: 6799254.

Парфенов А. Л., Разживин В. П., Петрова М. В. Хроническое критическое заболевание: современные аспекты проблемы (обзор). Современные технологии в медицине. 2022; 14 (3): 70–83. DOI: 10.17691/stm2022.14.3.08.

Parfenov A. L., Razzhivin V. P., Petrova M. V. Chronic critical illness: current aspects of the problem (review). Modern Technologies in Medicine = Sovrem Tekhnologii Med. 2022; 14 (3): 70–83. (in Russ.). DOI: 10.17691/stm2022.14.3.08.

Ohbe H., Satoh K., Totoki T., Tanikawa A.,Shirasaki K., Kuribayashi Y., Tamura M., et al.; J-STAD (JAPAN Sepsis Treatment and Diagnosis) Study Group. Definitions, epidemiology, and outcomes of persistent/chronic critical illness: a scoping review for translation to clinical practice. Crit Care. 2024; 28 (1): 435. DOI: 10.1186/s13054-024-05215-4. PMID: 39731183.

Liberati A., Altman D.G., Tetzlaff J., Mulrow C., Gøtzsche P.C., Ioannidis J.P.A., Clarke M., et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009; 62 (10): e1–34. DOI: 10.1016/j.jclinepi.2009.06.006. PMID: 19631507.

Iwashyna T.J., Hodgson C.L., Pilcher D., Orford N., Santamaria J.D., Bailey M., Bellomo R. Towards defining persistent critical illness and other varieties of chronic critical illness. Crit Care Resusc. 2015; 17 (3): 215–218. PMID: 26282262.

Desarmenien M., Blanchard-Courtois A.L., Ricou B. The chronic critical illness: a new disease in intensive care. Swiss Med Wkly. 2016: 146: w14336. DOI: 10.4414/smw.2016.14336. PMID: 27723899.

Шестопалов А.Е., Яковлева А.В., Лукьянец О.Б., Петрова М.В. Метаболические предикторы жизнеугрожающих состояний у больных в хроническом критическом состоянии. Клиническое питание и метаболизм. 2022; 3 (1): 38–49. DOI: 10.17816/clinutr105625.

Shestopalov A.E., Yakovleva A.V., Lukyanets O.B., Petrova M.V. Metabolic predictors of life-threatening conditions in patients in chronic critical illness. Clinical Nutrition and Metabolism=Klinicheskoye Pitanie i Metabolizm. 2022; 3 (1): 38–49. DOI: 10.17816/clinutr105625.

Daly B., Phelps W., Rudy E. A nurse-managed special care unit. J Nur Adm. 1991; (7–8): 31–38. PMID: 1870004.

Carson S., Bach P. The epidemiology and costs of chronic critical illness. Crit Care Clin. 2002; 18 (3): 461–476. DOI: 10.1016/s0749-0704(02)00015-5. PMID: 12140908.

MacIntyre N.R., Epstein S.K., Carson S., Scheinhorn D., Christopher K., Muldoon S. Management of patients requiring prolonged mechanical ventilation: report of a NANDRC consensus conference. Chest. 2005; 128 (6): 3937–3954. DOI: 10.1378/chest.128.6.3937. PMID: 16354866.

Zilberberg M.D., Luippold R.S., Sulsky S., Shorr A.F. Prolonged acute mechanical ventilation, hospital resource utilization, and mortality in the United States. Crit Care Med. 2008; 36 (3): 724–30. DOI: 10.1097/CCM.0B013E31816536F7. PMID: 18209667.

Hermans G., Van Aerde N., Meersseman P., Van Mechelen H., Debaveye Y., Wilmer A., Gunst J. et al. Five-year mortality and morbidity impact of prolonged versus brief ICU stay: a propensity score matched cohort study. Thorax. 2019; 74 (11): 1037–1045. DOI: 10.1136/thoraxjnl-2018-213020. PMID: 31481633

Iwashyna T.J., Hodgson C.L., Pilcher D., Bailey M., van Lint A., Chavan S., Bellomo R. Timing of onset and burden of persistent critical illness in Australia and New Zealand: a retrospective, population-based, observational study. Lancet Respir Med. 2016; 4 (7): 566–573. DOI: 10.1016/S2213-2600(16)30098-4. PMID: 27155770.

Bagshaw S.M., Stelfox H.T., Iwashyna T.J., Bellomo R., Zuege D., Wang X. Timing of onset of persistent critical illness: a multi-centre retrospective cohort study Springer. Intensive Care Med. 2018; 44 (12): 2134–2144. DOI: 10.1007/s00134-018-5440-1. PMID: 30421256.

Jeffcote T., Foong M., Gold G., Glassford N., Robbins R., Iwashyna T.J., Darvali J., et al. Patient characteristics, ICU-specific supports, complications, and outcomes of persistent critical illness. J Crit Care. 2019; 54: 250–255. DOI: 10.1016/j.jcrc.2019.08.023. PMID: 31630075.

Nierman D.M. A structure of care for the chronically critically ill. Crit Care Clin. 2002; 18 (3): 477–491. DOI: 10.1016/s0749-0704(02)00010-6. PMID: 12140909.

Nelson J.E., Cox C.E., Hope A.A., Carson S.S. Chronic critical illness. Am J Respir Crit Care Med. 2010; 182 (4): 446–454. DOI: 10.1164/rccm.201002-0210CI. PMID: 20448093.

Kandilov A.M., Ingber M., Morley M., Coomer N., Dalton K.,Gage B., Superina C., et al. Chronically Critically Ill Population Payment Recommendations (CCIP-PR). Final report. Research Triangle Park, NC: RTI International; 2014. 156 p. URL: https://www.cms.gov/priorities/innovation/Files/reports/ChronicallyCriticallyIllPopulation-Report.pdf. Accessed 05/06/2026.

«Реабилитация в отделении реанимации и интенсивной терапии (РеабИТ)» https://rehabrus.ru/Docs/2021/MR-ReabIT_3.0.pdf.

«Rehabilitation in the Department of Resuscitation and Intensive Care (ReabIT)» (in Russ.). (https://rehabrus.ru/Docs/2021/MR-ReabIT_3.0.pdf.

Белкин А.А., Рудник Е.Н., Белкин В.А., Нагаев Н.С., Пинчук Е.А., Рудник А.Е., Ткачук М.М. Разработка и валидация ПИТС-индекса для оценки тяжести синдрома последствий интенсивной терапии: описательное проспективное не сравнительное когортное исследование. Вестник интенсивной терапии имени А.И. Салтанова. 2024; 4: 58–72.

Belkin A.A., Rudnik E.N., Belkin V.A., Nagaev N.S., Pinchuk E.A., Rudnik A.E., Tkachuk M.M. Development and validation of the PICS index to assess the severity of the syndrome of consequences of intensive care: a descriptive prospective and unmatched cohort study. AnnCritCare=Vestnik Intensivnoy Terapii imeni A.I. Saltanova. 2024; 4: 58–72. (in Russ.).

Voiriot G., Oualha M., Pierre A., Gandonnière C.S., Gaudet A., Jouan Y., Kallel H., et al.; la CRT de la SRLF. Chronic critical illness and post-intensive care syndrome: from pathophysiology to clinical challenges. Ann Intensive Care. 2022; 12 (1): 58. DOI: 10.1186/s13613-022-01038-0. PMID: 35779142.

Shaw M., Viglianti E.M., McPeake J., Bagshaw S.M., Pilcher D., Bellomo R., Iwashyna T.J., et al. Timing of onset, burden, and postdischarge mortality of persistent critical illness in Scotland, 2005– 2014: a retrospective, population-based, observational study. Crit Care Explor. 2020; 2 (4): e0102. DOI: 10.1097/CCE.0000000000000102. PMID: 32426744

Viglianti E.M., Bagshaw S.M., Bellomo R., McPeake J.,Wang X.Q., Seelye S., Iwashna T.J. Hospital-level variation in the development of persistent critical illness. Intensive Care Med. 2020; 46 (8): 1567–1575. DOI: 10.1007/s00134-020-06129-9. PMID: 32500182.

Van den Berghe G. On the neuroendocrinopathy of critical illness. Perspectives for feeding and novel treatments. Am J Respir Crit Care Med. 2016; 194 (11): 1337–1348. DOI:10.1164/rccm.201607-1516CI. PMID: 27611700.

Lone N.I., Walsh T.S. Prolonged mechanical ventilation in critically ill patients: epidemiology, outcomes and modelling the potential cost consequences of establishing a regional weaning unit. Crit Care. 2011; 15 (2): R102. DOI: 10.1186/cc10117. PMID: 21439086.

Ohbe H., Matsui H., Fushimi K., Yasunaga H. Epidemiology of chronic critical illness in Japan: a nationwide inpatient database study. Crit Care Med. 2021; 49 (1): 70–78. DOI: 10.1097/CCM.0000000000004723. PMID: 33177360.

Chadda K.R., Puthucheary Z. Persistent inflammation, immunosuppression, and catabolism syndrome (PICS): a review of definitions, potential therapies, and research priorities. Br J Anaesth. 2024; 132 (3): 507–18. DOI: 10.1016/j.bja.2023.11.052. PMID: 38177003.

Viglianti E.M., Kramer R., Admon A.J., Sjoding M.W., Hodgson C.L., Bellomo R., Iwashyna T.J. Late organ failures in patients with prolonged intensive care unit stays. J Crit Care. 2018; 46: 55–57. DOI: 10.1016/j.jcrc.2018.03.029. PMID: 29684773.

Darvall J.N., Bellomo R., Bailey M., Young P.J., Rockwood K., Pilcher D. Impact of frailty on persistent critical illness: a population-based cohort study. Intensive Care Med. 2022; 48 (3): 343–351. DOI: 10.1007/s00134-022-06617-0. PMID: 35119497.

Rockwood K., Song X., MacKnight C., Bergman H., Hogan D.B., McDowell I., Mitnitski A. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005; 173 (5): 489–495. DOI: 10.1503/cmaj.050051. PMID: 16129869.

Okahara S., Subramaniam A., Darvall J.N. , Ryo Ueno R., Bailey M.M., David V. Pilcher D.V. The relationship between frailty and mechanical ventilation: a population-based cohort study. Ann Am Thorac Soc. 2022; 19 (2): 264–271. DOI: 10.1513/AnnalsATS.202102-178OC. PMID: 34214022.

Loss S.H., Marchese C.B., Boniatti M.M., Wawrzeniak I.C., Oliveira R.P., Nunes L.N., Victorino J.A. Prediction of chronic critical illness in a general intensive care unit. Rev Assoc Med Bras (1992). 2013; 59 (3): 241–247. DOI: 10.1016/j.ramb.2012.12.002. PMID: 23680275.

Jaiswal S., Sadacharam K., Shrestha R.R., Bhatta P., Ghimire R.K., Rimal A., Berhane Z., et al. External validation of prognostic model of one-year mortality in patients requiring prolonged mechanical ventilation. J Nepal Health Res Counc. 2012; 10 (1): 47–51. PMID: 22929637.

Feijó C.A.R., Borges A.E.P.P., da Cunha E.Q., de Meneses F.A., Albuquerque M.P., Natália LP Aragão N.L.P., Pinheiro T.O., et al. Chronic critical illness: reason for concern during and after ICU admission!. Crit Care. 2015; 19 (Suppl 2): P20. DOI: 10.1186/cc14674.

Mira J.C., Brakenridge S.C., Moldawer L.L., Moore F.A. Persistent inflammation, immunosuppression and catabolism syndrome. Crit Care Clin. 2017; 33 (2): 245–258. DOI: 10.1016/j.ccc.2016.12.001. PMID: 28284293.

Carson S.S., Garrett G., Hanson L.C., Lanier J., Govert J., Brake M.C., Landucci D.L., et al. A prognostic model for one-year mortality in patients requiring prolonged mechanical ventilation Crit Care Med. 2008; 36 (7): 2061–9. DOI: 10.1097/CCM.0b013e31817b8925. PMID: 18552692.

Udeh C.I., Hadder B., Udeh B.L. Validation and extension of the prolonged mechanical ventilation prognostic Mmodel (ProVent) ccore for predicting 1-year mortality after prolonged mechanical ventilation. Ann Am Thorac Soc. 2015; 12 (12): 1845–51. DOI: 10.1513/AnnalsATS.201504-200OC. PMID: 26418231.

Dibiasi C., Kimberger O., Bologheanu R., Staudinger T., Heinz G., Zauner C., G., et al. External validation of the ProVent score for prognostication of 1-yearmortality of critically ill patients with prolonged mechanical ventilation: a single-centre, retrospective observational study in Austria. BMJ Open. 2022; 12 (9): e066197. DOI: 10.1136/bmjopen-2022-066197. PMID: 36127078.

Hough C.L., Caldwell E.S., Cox C.E. ., Douglas I.S., Kahn J.M., White D.B., Seeley E.J.; the ProVent Investigators and the National Heart Lung and Blood Institute’s Acute Respiratory Distress Syndrome Network. Development and validation of a mortality prediction model for patients receiving 14 days of mechanical ventilation. Crit Care Med. 2015; 43 (11): 2339–2345. DOI: 10.1097/CCM.0000000000001205. PMID: 26247337.

Darvall J.N., Boonstra T., Norman J., Murphy D., Bailey M., Iwashyna T.J., Bagshaw S.M., et al. Persistent critical illness: baseline characteristics, intensive care course, and cause of death. Crit Care Resusc. 2019; 21 (2): 110–118. PMID: 31142241.

Unroe M., Kahn J.M., Carson S.S., Govert J.A., Martinu T., Sathy S.J., Clay A.S., et al. One year trajectories of care and resource utilization for recipients of prolonged mechanical ventilation: a cohort study. Ann Intern Med. 2010; 153 (3): 167–175. DOI: 10.7326/0003-4819-153-3-201008030-00007. PMID: 20679561.

Marchioni A., Tonelli R., Sdanganelli A., Gozzi F., Musaro L.,Fantini R., Tabbi L., et al. Prevalence and development of chronic critical illness in acute patients admitted to a respiratory intensive care setting. Pulmonology. 2020; 26 (3): 151–158. DOI: 10.1016/j.pulmoe.2019.09.006. PMID: 31672594.

Ершов В.И., Белкин А.А., Горбачев В.И., Грицан А.И., Заболотских И.Б., Лебединский К.М., Лейдерман И.Н., с совт. Российское многоцентровое обсервационное клиническое исследование «Регистр респираторной терапии у пациентов с ОНМК (RETAS)»: инфекционные осложнения при искусственной вентиляции легких. Анестезиология и реаниматология. 2023; 1: 19–25. DOI: 10.17116/anaesthesiology202301119.

Ershov V.I., Belkin A.A., Gorbachev V.I., Gritsan A.I., Zabolotskikh I.B., Lebedinsky K.M., Leyderman I.N., et al. Russian multicenter observational clinical study «Register of Respiratory Therapy in Patients with Ischemic Stroke (RETAS)»: infectious complications of mechanical ventilation. Russian Journal of Anaesthesiology and Reanimatology=Anesteziologiya i Reanimatologiya. 2023; 1: 19–25. (in Russ.). DOI: 10.17116/anaesthesiology202301119.

Ершов В.И., Лейдерман И.Н., Белкин А.А., Горбачев В.И., Грицан А.И., Лебединский К.М., Петриков С.С., с совт Распространенность и влияние белково-энергетической недостаточности на осложнения и исход тяжелого инсульта, требующего респираторной поддержки: многоцентровое проспективное наблюдательное исследование. Вестник интенсивной терапии им. А. И. Салтанова. 2024; 1: 58–68. DOI: 10.21320/1818-474X-2024-1-58-68.

Ershov V.I., Leyderman I.N., Belkin A.A., Gorbachev V.I., Gritsan A.I., Lebedinsky K.M., Petrikov S.S., et al. Protein-energy malnutrition prevalence and influence on complications and outcome of severe stroke requiring mechanical ventilation: a multicenter prospective observational trial. Ann Crit Care= Vestnik Intensivnoy Terapii im. A. I. Saltanova. 2024; 1: 58–68. (in Russ.). DOI: 10.21320/1818-474X-2024-1-58-68.

Téblick A., Langouche L., Van den Berghe G. Anterior pituitary function in critical illness. Endocr Connect. 2019; 8 (8): R131– R143. DOI: 10.1530/EC-19-0318. PMID: 31340197.

Boonen E., van den Berghe G. Endocrine responses to critical illness: novel insights and therapeutic implications. J Clin Endocrinol Metab. 2014; 99 (5): 1569–1582. DOI: 10.1210/jc.2013-4115. PMID: 24517153.

Schmidt H., Hoyer D., Wilhelm J., Söffker G., Heinroth K., Hottenrott K., Said S.M., et al. The alteration of autonomic function in multiple organ dysfunction syndrome. Crit Care Clin. 2008; 24 (1): 149–163,ix. DOI: 10.1016/j.ccc.2007.10.003. PMID: 18241783.

Wang W., Xu C., Ma X., Zhang X., Xie P. Intensive care unit-acquired weakness: a review of recent progress with a look toward the future. Front Med (Lausanne). 2020; 7: 559789. DOI: 10.3389/fmed.2020.559789. PMID: 33330523.

Macintyre N.R. Chronic critical illness: the growing challenge to health care. Respir Care. 2012; 57 (6): 1021–1027. DOI: 10.4187/respcare.01768. PMID: 22663975.

Pandharipande P.P., Girard T.D., Jackson J.C, Morandi A., Thompson J.L., Pun B.T., Brummel N.E., et al.; BRAIN-ICU Study Investigators. Long-term cognitive impairment after critical illness. N Engl J Med. 2013; 369 (14): 1306–1316. DOI: 10.1056/NEJMoa1301372. PMID: 24088092.

Cox C.E. Persistent systemic inflammation in chronic critical illness. Respir Care. 2012; 57 (6): 859–864. DOI: 10.4187/respcare.01719. PMID: 22663963.

Gentile L.F., Cuenca A.G., Efron P.A., Ang D., Bihorac A., McKinley B.A., Moldawer L.L., et al. Persistent inflammation and immunosuppression: a common syndrome and new horizon for surgical intensive care. J Trauma Acute Care Surg. 2012; 72 (6): 1491–1501. DOI: 10.1097/TA.0b013e318256e000. PMID: 22695412.

Hawkins R.B., Raymond S.L., Stortz J.A., Hiroguchi H., Brakenridge S.C., Gardner A., Efron P.A., et al. Chronic critical illness and the persistent inflammation, immunosuppression, and catabolism syndrome. Front Immunol. 2018; 9: 1511. DOI: 10.3389/fimmu.2018.01511. PMID: 30013565.

Zhou Q., Qian H., Yang A., Lu J., Liu J. Clinical and prognostic features of chronic critical illness/persistent inflammation immunosuppression and catabolism patients: a prospective observational clinical study. Shock. 2023; 59 (1): 5–11. DOI: 10.1097/SHK.0000000000002035. PMID: 36383370.

Likhvantsev V.V., Berikashvili L.B., Yadgarov M.Y., Yakovlev A.A., Kuzovlev A.N. The tri-steps model of critical conditions in intensive care: introducing a new paradigm for chronic critical illness. J Clin Med. 2024; 13: 3683. DOI: 10.3390/jcm13133683. PMID: 38999249.

Hesselink L., Hoepelman R.J., Spijkerman R., de Groot M.C.H., van Wessem K.J.P., Koenderman L., Leenen L.P.H., et al. Persistent inflammation, immunosuppression and catabolism syndrome (PICS) after polytrauma: a rare syndrome with major consequences. J Clin Med. 2020; 9 (1): 191. DOI: 10.3390/jcm9010191. PMID: 31936748.

Berikashvili L.B., Shestopalov A.E., Polyakov P.A., Yakovleva A.V., Yadgarov M.Y., Kuznetsov I.V., Said M.T.S.M., et al. The neurological metabolic phenotype in prolonged/chronic critical illness: propensity score matched analysis of nutrition and outcomes. Nutrients. 2025; 17 (14): 2302. DOI: 10.3390/nu17142302. PMID: 40732927.

The authors declare that there are no conflicts of interest present.