Slowing Down of Recovery as Generic Risk Marker for Acute Severity Transitions in Chronic Diseases

Critical Care Medicine
Marcel G M Olde RikkertMarten Scheffer

Abstract

We propose a novel paradigm to predict acute attacks and exacerbations in chronic episodic disorders such as asthma, cardiac arrhythmias, migraine, epilepsy, and depression. A better generic understanding of acute transitions in chronic dynamic diseases is increasingly important in critical care medicine because of the higher prevalence and incidence of these chronic diseases in our aging societies. PubMed, Medline, and Web of Science. We selected studies from biology and medicine providing evidence of slowing down after a perturbation as a warning signal for critical transitions. Recent work in ecology, climate, and systems biology has shown that slowing down of recovery upon perturbations can indicate loss of resilience across complex, nonlinear biologic systems that are approaching a tipping point. This observation is supported by the empiric studies in pathophysiology and controlled laboratory experiments with other living systems, which can flip from one state of clinical balance to a contrasting one. We discuss examples of such evidence in bodily functions such as blood pressure, heart rate, mood, and respiratory regulation when a tipping point for a transition is near. We hypothesize that in a range of chronic episodic d...Continue Reading

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Citations

Sep 17, 2016·BMC Neuroscience·Carolyn E SchwartzBrian C Healy
Apr 19, 2018·Journal of the American Geriatrics Society·Matthew Dl O'ConnellRose Anne Kenny
Jul 28, 2018·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Sanne M W GijzelRené J F Melis
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Oct 31, 2018·Proceedings of the National Academy of Sciences of the United States of America·Marten SchefferMarcel G M Olde Rikkert
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Jun 12, 2021·Science·Babak M S AraniMarten Scheffer

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