. Author manuscript; available in PMC: 2013 Jul 9.

Published in final edited form as: J Trauma Acute Care Surg. 2012 Jun;72(6):1491–1501. doi: 10.1097/TA.0b013e318256e000

Table 3.

Clinical Determinants of PICS	Research or Laboratory Methodologies
Persistent Prolonged hospitalization >14 days Inflammation C-reactive protein > 150 μg/dl Immunosuppression Total lymphocyte count < 800/mm³ Catabolism Weight loss of >10% during hospitalization or BMI< 18 Creatinine Height Index < 80% Albumin< 3.0 gm/dl Pre-albumin< 10 mg/dl Retinol binding protein< 10 μg/dl	Inflammation Luminex^™ for cytokine concentrations-IL-6, IL-10, IL-1ra, procalcitonin Leukocyte genome expression patterns, e.g. ARG1, NOS2, IL-1RA, SILR2, MMP8, MMP9, MMP2 Immunosuppression ‘Paralyzed Monocyte’ Reduced ex vivo cytokine production Reduced HLA-DR expression Reduced phagocytosis Anergy or Exhausted T cell Expression of suppressor molecules, e.g. PDL-1, CTLA-4, BTLA, HVEM Reduced T-cell proliferation T_H2 repolarization – Increased Treg numbers and suppressor activity

Clinical Determinants of PICS

Research or Laboratory Methodologies

Inflammation
- Luminex^™ for cytokine concentrations-IL-6, IL-10, IL-1ra, procalcitonin
- Leukocyte genome expression patterns, e.g. ARG1, NOS2, IL-1RA, SILR2, MMP8, MMP9, MMP2
Immunosuppression
- ‘Paralyzed Monocyte’
- Reduced ex vivo cytokine production
- Reduced HLA-DR expression
- Reduced phagocytosis
Anergy or Exhausted T cell
- Expression of suppressor molecules, e.g. PDL-1, CTLA-4, BTLA, HVEM
- Reduced T-cell proliferation
- T_H2 repolarization
- – Increased Treg numbers and suppressor activity