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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2016 January;82(1):84-96

language: English

The evolution of nutritional support in long term ICU patients: from multisystem organ failure to persistent inflammation immunosuppression catabolism syndrome

Martin ROSENTHAL 1, Andrea GABRIELLI 2, Frederick MOORE 1

1 Division of Acute Care Surgery, Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA; 2 Division of Anesthesia and Critical Care Medicine, Department of Anesthesia, University of Florida College of Medicine, Gainesville, FL, USA


Multiple organ failure (MOF) is an evolving pathologic phenotype that plagues intensive care units globally. This manuscript aims to depict the evolution of single organ failure through multiple organ failure, ending in the newest phenotype called persistent inflammation, immunosuppression, catabolism syndrome (PICS). Among the other MOF phenotypes discussed are systemic inflammatory response syndrome (SIRS) and compensatory anti-inflammatory response syndrome. Along with a review of the four phenotypes of MOF there is a review of the current literature on nutritional supplementation. Discussed in these sections are possible etiologies for the various progression of MOF, total enteral nutrition (TPN) versus early enteral nutrition (EEN), early versus late parenteral nutrition, glycemic control, and new enteral formulas. Finally, as the newest phenotype, PICS, has evolved we try to make inferences from similar pathologic states to recommend nutritional support that has proven beneficial.

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