Prolonged inflammation following critical illness may impair long-term survival: a hypothesis with potential therapeutic implications

Grander, Wilhelm; Dünser, Martin Wolfgang (2010). Prolonged inflammation following critical illness may impair long-term survival: a hypothesis with potential therapeutic implications. Medical hypotheses, 75(1), pp. 32-4. Amsterdam: Elsevier 10.1016/j.mehy.2010.01.020

Full text not available from this repository. (Request a copy)

Despite successful intensive care a substantial portion of critically ill patients dies after discharge from the intensive care unit or hospital. Observational studies investigating long-term survival of critically ill patients reported that most deaths occur during the first months or year after discharge. Only limited data on the causes of impaired quality of life and post-intensive care unit deaths exist in the current literature. In this manuscript we hypothesize that the acute inflammatory response which characteristically accompanies critical illness is ensued by a prolonged imbalance or activation of the immune system. Such a chronic low-grade inflammatory response to critical illness may be sub-clinical and persist for a variable period of time after discharge from the intensive care unit and hospital. Chronic inflammation is a well-recognized risk factor for long-term morbidity and mortality, particularly from cardiovascular causes, and may thus partly contribute to the impaired quality of life as well as increased morbidity and mortality following intensive care unit and hospital discharge of critically ill patients. Assuming that critical illness is indeed followed by a prolonged inflammatory response, important implications for treatment would arise. An interesting and potentially beneficial therapy could be the administration of immune-modulating drugs during the time after intensive care unit or hospital discharge until chronic inflammation has subsided. Statins are well-investigated and effective drugs to attenuate chronic inflammation and could potentially also improve long-term outcome of critically ill patients after intensive care unit or hospital discharge. Future studies evaluating the course of inflammation during and after critical illness as well as its response to statin therapy are required.

Item Type:	Journal Article (Original Article)
ISSN:	0306-9877
Publisher:	Elsevier
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 14:09
Last Modified:	04 Feb 2015 13:32
Publisher DOI:	10.1016/j.mehy.2010.01.020
PubMed ID:	20138436
Web of Science ID:	000279409400007
URI:	https://boris.unibe.ch/id/eprint/1166 (FactScience: 202031)