Catabolism and nutritional support in chronic critical illness

doi:10.3877/cma.j.issn.2096-1537.2025.04.009

Abstract

Abstract:

With the continuous advancement of critical care medicine, early mortality among critically ill patients has significantly declined. However, a subset of survivors continue to experience persistent multi-organ dysfunction, requiring prolonged stays in the intensive care unit (ICU). These patients are clinically defined as having chronic critical illness (CCI). Notably, CCI is characterized by marked hypercatabolism, which severely impacts prognosis and quality of life. This article systematically reviews the definition, epidemiology, and pathophysiological mechanisms of hypercatabolism in CCI, including the roles of sustained inflammatory responses, neuroendocrine dysregulation, and their effects on tissue metabolism—particularly skeletal muscle catabolism. Furthermore, we summarize biomarkers associated with hypercatabolism in CCI patients and evaluate the critical role of nutritional support strategies, such as enteral nutrition, nutritional adjuvants, and anabolic agents, in mitigating metabolic dysregulation. By synthesizing current evidence, this review aims to provide reference for optimizing nutrition-focused interventions in CCI patients, ultimately improving clinical outcomes and guiding future research directions in this evolving field.

Key words: Chronic critical illness, Catabolism, Nutritional support

Wanting Su, Renyu Ding. Catabolism and nutritional support in chronic critical illness[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2025, 11(04): 387-396.

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