Metabolic predictors of life-threatening conditions in patients in chronic critical illness

Abstract

Due to modern advances in medicine, more and more patients survive after severe acute diseases. However, some such patients remain dependent on life-support systems. Therefore, a chronic critical condition is an urgent problem for patients in the intensive care unit. The main syndrome of this complex is maladaptive responses to long-term existing stress factors. This review examines the main pathophysiological mechanisms of chronic critical illness, as well as the resulting metabolic disorders. A literature search was conducted in the English-language databases of medical and biological publications PubMed and Scopus, as well as the Russian bibliographic system RSCI. The coverage interval was the last 20 years. Emphasis was placed on the systemic inflammatory reaction; the reaction of hypermetabolism-hypercatabolism; disorders of carbohydrate, protein, and fat metabolism; and the development of secondary sarcopenia. In conclusion, the volume of metabolic control and intensive nutritional and metabolic support, which are critical components of a comprehensive approach to the treatment of chronic critical illness, are key considerations considered.