Systemic inflammatory response syndrome

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MeshID = In medicine, systemic inflammatory response syndrome (SIRS) is an inflammatory state of the whole body (the "system") without a proven source of infection. It is a medical emergency.

Definition of SIRS

Criteria for SIRS were agreed upon in 1992. [cite journal |author= |title=American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis |journal=Crit. Care Med. |volume=20 |issue=6 |pages=864–74 |year=1992 |pmid=1597042 |doi=] SIRS can be diagnosed when two or more of the following are present:Irwin RS, Cerra FB, Rippe JM. Irwin and Rippe's Intensive Care Medicine. 5th Ed. Lippincott Williams & Wilkins. Hagerstown, MD. 2003. ISBN 0-7817-1425-7. [http://www.lww.com/product/?0-7817-3548-3 Publisher's information on the book] .] Marino PL. The ICU Book. 2nd Ed. Lippincott Williams & Wilkins. Hagerstown, MD. 1998. ISBN 0-683-05565-8. [http://www.lww.com/product/?0-683-05565-8 Publisher's information on the book] .] [Sharma S, Steven M. Septic Shock. eMedicine.com, URL: http://www.emedicine.com/MED/topic2101.htm Accessed on Nov 20, 2005.] Tslotou AG, Sakorafas GH, Anagnostopoulos G, Bramis J. Septic shock; current pathogenetic concepts from a clinical perspective. Med Sci Monit. 2005 Mar;11(3):RA76-85. PMID 15735579. [http://www.medscimonit.com/pub/vol_11/no_3/4318.pdf Full Text] .]
* Heart rate > 90 beats per minute
* Body temperature < 36 or > 38°C
* Tachypnea (high respiratory rate) > 20 breaths per minute or, on blood gas, a P_aCO₂ < 4.3 kPa (32 mm Hg)
* White blood cell count < 4000 cells/mm³ or > 12000 cells/mm³ (< 4 x 10⁹ or > 12 x 10⁹ cells/L), or the presence of greater than 10% immature neutrophils.

Difference between SIRS and sepsis

SIRS due to a suspected or proven infection is called sepsis.

Simply stated: :"SIRS + infection = sepsis"

Complications of SIRS

Severe sepsis, defined as sepsis with one or more organ failure.
SIRS can result in the multiple organ dysfunction syndrome.
Hypotension related to vessel dilation
Hypovolemic shock

Causes of SIRS

* Severe trauma
* Surgery, complication of
* Adrenal insufficiency
* Pulmonary embolism
* Complicated aortic aneurysm
* Myocardial infarction
* Hemorrhage
* Cardiac tamponade
* Anaphylaxis
* Drug overdose
* Burns
* Acute pancreatitis
* Immunodeficiency (such as AIDS [Santhanam S, Tolan RW. Sepsis. eMedicine.com, URL: http://www.emedicine.com/ped/topic3033.htm Accessed on Mar 12, 2006.] )

Relation to cytokine storm

SIRS can be considered to be a subset of "cytokine storm", a general term (not commonly used in clinical medicine) for cytokine dysregulation.

ee also

* Sepsis
* Shock
* Septic shock

References