Metabolic predictors of life-threatening conditions in patients in chronic critical condition (review)

Due to the modern level of development of medicine, more and more patients survive after severe acute diseases. However, some of the 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 response to long-term existing stress factors. This review examines the main pathophysiological mechanisms of chronic critical illness, as well as the resulting metabolic disorders. Emphasis is placed on the systemic inflammatory reaction, the reaction of hypermetabolism - hypercatabolism, disorders of carbohydrate, protein and fat metabolism, the development of secondary sarcopenia. In conclusion, the volume of metabolic control and intensive nutritional and metabolic support, which are an important component of a comprehensive approach to the treatment of chronic critical illness, are also considered.