Early and aggressive management has significantly improved mortality after sepsis. However, we are finding that those who survive sepsis or septic shock may progress to a state of chronic critical illness and often develop PICS, which leads to poor outcomes, multiple complications, and prolonged recovery times. The mechanisms behind PICS, however, are not completely understood and no therapies for it currently exist. We have created the first murine model of PICS and are just beginning to learn the mechanisms behind the immunosuppression that occurs. It seems that early recognition and intervention may be the key to mitigating its progression.
- Nomellini V, Kaplan LJ, Sims C, Caldwell CC. 2017. Chronic Critical Illness and Innate Immune Paralysis: What Can We Learn from the Elderly, Septic, Injured, and Malnourished? Shock. 49:4-14.
- Pugh, AM, Goetzman, HS, Caldwell, CC, Nomellini, V. 2017. A Murine Model of the Persistent Inflammation, Immune Suppression, and Catabolism Syndrome. Int J Mol Sci. 18(8).
- Winer LK, Beckmann N, Veile RE, Goodman M.D., Caldwell CC, Nomellini V. 2019 Consumptive coagulopathy is associate with organ dysfunction during PICS. American Journal of Physiology-Lung Cellular and Molecular Physiology. E-published.
- Tobin JM, Gavitt BJ, Nomellini V, Dobson GP, Letson HL, Shackelford SA. 2020. Immunotherapeutic options for inflammation in trauma. J Trauma and Acute Care Surg. 89:S77-S82.
- Satarupa S, Caldwell CC, Nomellini V. 2020. Distinct neutrophil populations in the spleen during PICS. Frontiers in Immunology. 11:804.
- Winer LK, Salyer CE, Beckmann N, Caldwell CC, Nomellini V. 2020. Enigmatic role of coagulopathy among sepsis survivors: a review of coagulation abnormalities and their possible link to chronic critical illness. Trauma Surg Acute Care Open. 5:e000462.