Nutrition for Chronic Critical Illness and Persistent Inflammatory, Immunosuppressed, Catabolic Syndrome

  • Martin D. RosenthalEmail author
  • Amir Y. Kamel
  • Michelle P. Brown
  • Angela C. Young
  • Jayshil J. Patel
  • Frederick A. Moore


The hallmark of chronic critical illness (CCI) and persistent inflammatory, immunosuppressed, catabolic syndrome (PICS) is the continued breakdown of lean muscle leading to profound weakness, decreased capacity for rehabilitation, immunosuppression, and a propensity to develop recurrent nosocomial infections. Better critical care support systems and advances in technology have led to increased patient survival, but unfortunately, CCI and PICS have emerged as a frequent phenotype among critical care survivors. With an aging population and continued advancements in critical care support systems, the prevalence of CCI and PICS is anticipated to increase. Unfortunately, therapies to mitigate or reverse CCI and PICS are limited. A lack of randomized controlled trials has limited strong recommendations for nutrition support in the CCI patients. Nutritional therapies for PICS may be of biologic value, and this chapter will describe recent advances and draw inferences from the literature to support nutritional interventions in PICS.


Chronic critical illness High protein Malnutrition Persistent inflammatory, immunosuppressed, catabolic syndrome PICS 



The investigators acknowledge the contribution of the Center for Sepsis and Critical Illness Award # P50 GM-111152 from the National Institute of General Medical Sciences.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Martin D. Rosenthal
    • 1
    Email author
  • Amir Y. Kamel
    • 2
  • Michelle P. Brown
    • 2
  • Angela C. Young
    • 2
  • Jayshil J. Patel
    • 3
  • Frederick A. Moore
    • 1
  1. 1.Department of Surgery, Division of Acute Care Surgery and Center for Sepsis and Critical Illness Research, University of Florida College of MedicineGainesvilleUSA
  2. 2.Department of Pharmacy, UF Health, University of Florida College of PharmacyGainesvilleUSA
  3. 3.Department of Medicine, Division of Pulmonary & Critical Care Medicine, Medical College of WisconsinMilwaukeeUSA

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