
Post-intensive care syndrome results from continuous inflammation - JPLeRouzic
https://padiracinnovation.org/News/2020/02/post-intensive-care-syndrome-results-from-continuous-inflammation
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post_below
This topic is interesting to me for a few reasons...

Cognitive impairment has long been associated with inflammation in older
adults:
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390758/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390758/)

As well as the general population where illness is involved:
[https://psychcentral.com/news/2019/12/01/inflammation-
linked...](https://psychcentral.com/news/2019/12/01/inflammation-linked-to-
the-brain-fog-of-chronic-illness/152083.html)

And it contributes to a variety of disorders (potentially almost all of them).
The research here is pretty broad, Google if interested. Notably, depression,
anxiety and other behavior impacting problems are among the aforementioned
disorders.

We know that exercise levels and diet can lower or increase inflammation.

So we have this sort of rare magic bullet when it comes to health, cognition
and aging. Lowering inflammation won't fix everything of course, but it will
lower your risk of pretty much everything.

And yet this truth is less a part of the zeitgeist than you'd expect, given
it's impact. Maybe because it's simple but not easy to change your lifestyle.
Or more importantly, the lifestyles of a population. Especially when part of
the problem is financial insecurity.

~~~
AstralStorm
Big part of the problem is that inflammation is beneficial, only chronic
inflammation is a problem. But treatments would reduce both.

~~~
lostlogin
> Big part of the problem is that inflammation is beneficial, only chronic
> inflammation is a problem.

But what about anaphylaxis, hay fever, mild allergies etc. There are plenty of
acute or non-chronic inflammatory conditions that are a problem.

~~~
AstralStorm
We have acute antiinflammatories for these cases. And they have serious side
effects, especially treatments for asthmatics.

Now interesting part here is the mechanism which is different from the one
targeted by current drugs.

------
doctoring
This article brings up a specific inflammation-related protein (HMGB1) as
being correlated with cognitive impairment after an ICU stay.

Usually an ICU stay is the result of being profoundly and dangerously ill --
going to the ICU likely means that you need significant pharmacological and/or
mechanical assistance in the basic things like... circulating blood. Or
oxygenation. And once there, you may have tubes/catheters/wires in various
orifices and puncturing vessels and organs. You're often medically sedated,
and if you become too awake or agitated, you are sedated further.
Unsurprisingly, many patients become agitated or delirious -- they don't know
where they are or when it is or maybe even who they are. Which makes things
worse. I mean, imagine it -- maybe you wake up in the midst of this horrendous
state of affairs, and you become understandably upset and confused, but if you
move around or holler (if you can) you may well get further sedated.
Repeatedly. The cognitive impact of this alone can understandably be immense.

I don't mean to say that ICUs are some evil thing, though surely they could be
improved. But the causes of "post-intensive care syndrome" are undoubtedly
enormously multi-factorial, what with the level of derangement and insult to
your body (and especially your mind!) from whatever illness led to you the ICU
to begin with, and the experience of being there. And as such I am skeptical
that this single protein could be terrifically useful either as a marker of or
a therapeutic target for cognitive impairment in this setting.

(I think as protein mass spec and other technologies improve, we might gain a
better understanding of how sets of dozens or hundreds of proteins in the body
may be related to disease states, and perhaps therapies will target
combinations of proteins or more complex interactions rather than "blocks this
one protein".)

~~~
hansthehorse
I spent 6 weeks in the ICU, half of them in a coma and intubated, it took me
weeks to feel my brain was working normally when I was released to a normal
recovery floor. I was confused, a little delirious and my memory was screwed
up.

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throwawayiIiIII
I'm in my thirties and had unresolved medical issues for a decade. And in that
time experienced much of our health system including visiting psychologists
and taking antidepressants. And nothing really helped. The only thing that
happened is that I learned to live with it.

The only constant in all is an allergy and a cyst causing constant swelling
and inflammation. The technical appearance of this, and lab results, never
looks very bad, and doctors are quick to discard the cyst as a source of my
problems.

I'm at the end of my wits, and my mind and body are deteriorating further and
I find it hard to muster up the energy to try and resolve this with ever more
visits to doctors. My physicians are not concerned enough to try and resolve
this quickly, because I still appear fine. I can function normally for a
while. But working 9-5 and having a life is honestly above my limit. I don't
dare press the issue too much because doctors are quick to jump to
psychological-issues-are-the-source
([https://en.wikipedia.org/wiki/Somatic_symptom_disorder](https://en.wikipedia.org/wiki/Somatic_symptom_disorder))
. Physician visits and different things are spaced so widely that a lot of
times passes, and I'm still supposed to wait longer and go step-by-step.

After all this time, and a lot chasing ideas and trying out smaller remedies,
I arrived at the conclusion/idea that it was the cyst and the inflammation and
possibly recurrent colonisation with bacertia from it all along. The cyst that
I was told was not an issue.

It's a miracle that I founded and still have a family. I appreciate all the
good things I received and achieved, but honest to god large parts of the way
were miserable, and I'm afraid to find out that it's not going to get better.

P.S.: Sorry for venting

~~~
treeman79
Somewhat similar. 3 years of intense effort to find out what was wrong.

Constantly told it was depression or anxiety.

Turned out it was an auto immune problem.

Anti depressants made me care less about problems but didn’t fix them.

------
moron4hire
"Humans and other mammals have two seahorses, one on each side of the brain."

Today I learned that "hippocampus" comes from the Greek for "seahorse",
because it looks like a seahorse: [https://images.squarespace-
cdn.com/content/v1/52ec8c1ae4b047...](https://images.squarespace-
cdn.com/content/v1/52ec8c1ae4b047ccc14d6f29/1401116742160-BW61VD07X8QHB0SGLKTP/ke17ZwdGBToddI8pDm48kOBdF5AVPuzIOxEwrx32HQFZw-
zPPgdn4jUwVcJE1ZvWQUxwkmyExglNqGp0IvTJZamWLI2zvYWH8K3-s_4yszcp2ryTI0HqTOaaUohrI8PIdA6tiAU9a4cuM3x7ZBNFhV-
CVYwxBdv3a47FjvKvB2MKMshLAGzx4R3EDFOm1kBS/hippocampus_seahorse.jpg)

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RcouF1uZ4gsC
I am not sure you need inflammation as an explanation. People in the ICU are
there because they are extremely sick. Often they have problems with blood
pressure and oxygenation. This probably leads to neuron death. In addition,
because they are getting checked on continuously they likely have poor sleep
and loss of day-night cycles. I am not sure how you can differentiate between
very sick people are in the ICU, and very sick people often have a lot of
inflammation.

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14
This makes me wonder what is happening during an extreme tooth ache. During
those times when I have had a bad tooth it is like my mind is in slow motion
and the ability to think is gone. I have had extreme pain and still been able
to think clearly but with an inflamed tooth it’s a different experience.

~~~
DoreenMichele
Teeth are fairly near the brain and are part of the skeleton. Except for
teeth, bone infections are typically considered to be very, very serious.

Bone marrow is an important part of the immune system. White blood cells and
what not originate there.

I feel like if you look at a tooth ache as a skeletal issue, the seriousness
of it begins to make more sense.

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hoopism
Anyone know if this is anyway related to PANDAS condition (RE: inflammation ->
cognitive changes)? We were recently introduced to the condition and my
understanding is the theory is inflammation is caused by the bodies immunity
response to strep virus (I might be off on that explanation). The idea
inflammation could give rise to cognitive impairments/changes would appear to
lend some credence (or maybe that is just already established??). We have a
daughter who checks some of the boxes on what people describe as the condition
and are just getting an understanding.

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allovernow
Here's something I've never understood, although I suspect the question is an
open one even among medical professionals:

Given that inflammation is an immune response, is it the inflammation itself
that's bad, or the underlying condition? If we only treated inflammation
symptoms without curing any of the underlying diseases, would there be a
significant improvement in outcomes? Or would they be worse because you'd be
interfering with the body's response?

~~~
lnanek2
There's plenty of cases where inflammation is not helpful at all, such as
arthritis and psoriasis. When the body is attacking itself in an immune
disorder, there's really no down side to preventing the body from attacking
itself. Unfortunately, such disorders become more and more common the older
you get, so you can think of it as the immune system accidentally triggering
rather than it triggering too much on some particular thing.

It's true, though, that for really severe inflammation disorders that doctors
start prescribing systemic immunosuppressants, which then result in the
patient getting real illnesses more often. Often the patient has such a bad
condition at that point - my psoriasis leads to skin flaking off in bloody
patches and smearing blood on the things I touch and my hands feeling like
sand paper to other people, for example - that they prefer this overall.

Even the localized topical immunosuppressants like hydrocortisone cream have
negative side effects like skin thinning, but I think everyone using those
agrees it's better than the extra inflammation.

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DoreenMichele
Sounds similar to _chemo brain,_ which is mental impairment that happens in
cancer patients as a side effect of treatment.

