Persistent inflammation, immunosuppression, and catabolism syndrome

Reduced early mortality in sepsis and severe injuries led to the formation of a cohort of patients with chronic critical conditions (diseases). One of the mechanisms of chronization of acute critical conditions is the development of persistent inflammation, immunosuppression and catabolism syndrome (PICS). Diagnosis of PICS is currently based on clinical and laboratory markers, whereas morphological changes insufficiently studied. Lack of pathogenesis and morphogenesis understanding makes it difficult to stratify patients with prolonged critical conditions and develop new treatment approaches, and also leads to the absence of PICS in clinical and anatomical diagnoses. The article systematized current understanding of PICS mechanisms of development and morphological manifestations. Examples of clinical cases are presented.