While much is known about inflammation during acute critical illness, as yet little is known about inflammation that persists after ICU discharge. And no studies on the association between inflammation and physical recovery were identified by the authors of a systematic review published in the Journal of Critical Care. Their review is intended as a first step in exploring the hypothesis that exposure to systemic inflammation after ICU causes post-ICU disability.

The reviewers, led by David M. Griffith, MD, from the  Department of Anaesthesia, Critical Care and Pain Medicine, Edinburgh Medical School, University of Edinburgh, UK, reviewed 22 studies of ICU patients aged over 16, who had a clinical or biochemical marker of systemic inflammation measured, and included publications up to December 2011.

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The reviewers note that the considerable heterogeneity of the study populations under study and high risk of selection bias precluded meta-analysis. They conclude that the available data do not appear to address the key question of inflammatory mediation of functional recovery, as no studies have reported correlations between inflammatory biomarkers and physical recovery outcomes. They add that the review provides initial evidence that the exposure of interest is present in the early post-ICU period but highlights the need for research into the key processes involved as the patient transitions into the community.

“This may allow us to better identify patients likely to experience a poor recovery trajectory to specifically target physical interventions and potentially to identify processes that might be amenable to pharmacological intervention. It is hoped that these together will improve functional recovery for ICU survivors in the future”, they write.

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References:

Griffith DM, Vale ME, Campbell C, Lewis S, Walsh TS (2016) Persistent inflammation and recovery after intensive care: a systematic review. J Crit Care, Jan 13. pii: S0883-9441(16)00012-5. doi: 10.1016/j.jcrc.2016.01.011. [Epub ahead of print] 



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inflammation, physical recovery, post-ICU While much is known about inflammation during acute critical illness, as yet little is known about inflammation that persists after ICU discharge. And no studies on the association between inflammation and physical recovery were identified by the authors