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Persistent Inflammation, Immunosuppression and Catabolism Syndrome in Pediatric Populations: A Brief Perspective

Michael D Santarelli1, Kelly A Davis2, Ryan J Stark1

  • 1Department of Pediatrics, Pediatric Critical Care Medicine, Vanderbilt University Medical Center, Nashville, United States.

Current Pediatric Reviews
|May 16, 2024
PubMed

Insights

Critically ill children can develop Persistent inflammation, Immunosuppression, and Catabolism Syndrome (PICS). Understanding PICS pathophysiology is crucial for developing new pediatric therapies and interventions.

Area of Science:

  • Pediatric critical care medicine
  • Immunology
  • Pathophysiology

Background:

  • Advances in medical care improve survival from critical illnesses like sepsis and trauma.
  • This improved survival has led to an increase in chronically critically ill children.
  • Many of these children exhibit Persistent inflammation, Immunosuppression, and Catabolism Syndrome (PICS), a pathological immunophenotype.

Purpose of the Study:

  • To provide an updated perspective on PICS in the pediatric population.
  • To highlight the need for understanding PICS pathophysiology for therapeutic development.

Main Methods:

  • This is a perspective piece, synthesizing current knowledge on PICS in children.
  • It reviews the hallmarks of PICS observed in critically ill pediatric patients.

Main Results:

  • Critically ill children can present with PICS, characterized by lymphopenia, hyperinflammation, and catabolism.
  • These PICS hallmarks are associated with recurrent infections and poorer outcomes in children.

Conclusions:

  • PICS is a significant concern in pediatric critical care.
  • Further research into PICS pathophysiology is essential for developing effective interventions and improving outcomes for these vulnerable children.

Keywords:
Chronic critical illnesscatabolism syndromeimmunosuppressionlymphopeniapediatric persistent inflammationsepsistrauma.

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