Systemic inflammatory response syndrome

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Overview

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 serious medical condition.

Definition of SIRS

Criteria for SIRS were agreed in 1992.^[1] SIRS can be diagnosed when two or more of the following are present^[2][3][4][5]:

• 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 with a suspected or proven infection is called sepsis.

Simply stated:

SIRS + infection = sepsis ^[2][3]

Complications of SIRS

SIRS can result in the multiple organ dysfunction syndrome.

Causes of SIRS

• Severe trauma
• Surgery, complication of
• Burns
• Acute pancreatitis
• Immunodeficiency (such as AIDS^[6])

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.

See also

• Sepsis
• Shock
• Septic shock

References

1. ↑ (1992) "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". Crit. Care Med. 20 (6): 864-74. PMID 1597042.
2. ↑ ^{2.0 2.1} 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. Publisher's information on the book.
3. ↑ ^{3.0 3.1} Marino PL. The ICU Book. 2nd Ed. Lippincott Williams & Wilkins. Hagerstown, MD. 1998. ISBN 0-683-05565-8. Publisher's information on the book.
4. ↑ Sharma S, Steven M. Septic Shock. eMedicine.com, URL: http://www.emedicine.com/MED/topic2101.htm Accessed on Nov 20, 2005.
5. ↑ 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. Full Text.
6. ↑ Santhanam S, Tolan RW. Sepsis. eMedicine.com, URL: http://www.emedicine.com/ped/topic3033.htm Accessed on Mar 12, 2006.

Textbooks

• Intensive Care Medicine by Irwin and Rippe
• Critical Care Medicine The Essentials by Marini and Wheeler
• The ICU Book by Marini and Sutin
• Cecil Textbook of Medicine
• The Oxford Textbook of Medicine
• Harrison's Principles of Internal Medicine

External link

• Bacteremia and Septic Shock (Merck Manual) - explains the usage of the terms bacteremia, septic shock, sepsis and septicemia.

v • d • e Health Science · Medicine · Medical specialities · Intensive care medicine / Critical care medicine and Critical care nursing
General terms	Intensive care unit (ICU) · Neonatal intensive care unit (NICU) · Pediatric intensive care unit (PICU) · Coronary care unit (CCU) · Critical illness insurance
Conditions	Organ system failure Acute renal failure · Acute respiratory distress syndrome · Acute liver failure · Cardiogenic shock · Coma · Distributive shock · Multiple organ dysfunction syndrome · Polytrauma · Respiratory failure · Sepsis · Septic shock · Shock · Systemic inflammatory response syndrome Complications Critical illness polyneuropathy / myopathy · Critical illness–related corticosteroid insufficiency · Decubitus ulcers · Fungemia · Stress hyperglycemia · Stress ulcer Iatrogenesis Methicillin-resistant Staphylococcus aureus · Oxygen toxicity · Refeeding syndrome · Ventilator-associated lung injury · Ventilator-associated pneumonia
Diagnosis	Arterial blood gas · Arterial catheter · Blood cultures · Central venous catheter · Pulmonary artery catheter · Screening cultures
Life supporting treatments	Airway management · Chest tube · Dialysis · Enteral feeding · Goal-directed therapy · Induced coma · Mechanical ventilation · Therapeutic hypothermia · Total parenteral nutrition
Drugs	Analgesics · Antibiotics · Antithrombotics · Inotropes · Intravenous fluids · Neuromuscular-blocking drugs · Recombinant activated protein C · Sedatives · Stress ulcer prevention drugs · Vasopressors
ICU scoring systems	APACHE II · Glasgow Coma Scale · PIM2 · SAPS II · SAPS III · SOFA
Organisations	Society of Critical Care Medicine · Surviving Sepsis Campaign
Related specialties	Anesthesia · Cardiology · Internal medicine · Neurology · Pediatrics · Pulmonology · Surgery · Traumatology

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Articles on Systemic inflammatory response syndrome	Most recent articles on Systemic inflammatory response syndrome • Most cited articles on Systemic inflammatory response syndrome • Review articles on Systemic inflammatory response syndrome • Articles on Systemic inflammatory response syndrome in N Eng J Med, Lancet, BMJ
Media (Slides, Video, Images, MP3) on Systemic inflammatory response syndrome	Powerpoint slides on Systemic inflammatory response syndrome • Images of Systemic inflammatory response syndrome • Photos of Systemic inflammatory response syndrome • Podcasts & MP3s on Systemic inflammatory response syndrome • Videos on Systemic inflammatory response syndrome
Evidence Based Medicine Regarding Systemic inflammatory response syndrome	Cochrane Collaboration on Systemic inflammatory response syndrome • Bandolier on Systemic inflammatory response syndrome • TRIP on Systemic inflammatory response syndrome
Cost Effectiveness of Systemic inflammatory response syndrome	Cost Effectiveness of Systemic inflammatory response syndrome
Clinical Trials Involving Systemic inflammatory response syndrome	Ongoing Trials on Systemic inflammatory response syndrome at Clinical Trials.gov • Trial results on Systemic inflammatory response syndrome • Clinical Trials on Systemic inflammatory response syndrome at Google
Guidelines / Policies / Government Resources (FDA/CDC) Regarding Systemic inflammatory response syndrome	US National Guidelines Clearinghouse on Systemic inflammatory response syndrome • NICE Guidance on Systemic inflammatory response syndrome • NHS PRODIGY Guidance • FDA on Systemic inflammatory response syndrome • CDC on Systemic inflammatory response syndrome
Textbook Information on Systemic inflammatory response syndrome	Books and Textbook Information on Systemic inflammatory response syndrome
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Genetics, Pharmacogenomics, and Proteinomics of Systemic inflammatory response syndrome	Genetics of Systemic inflammatory response syndrome • Pharmacogenomics of Systemic inflammatory response syndrome • Proteomics of Systemic inflammatory response syndrome
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Healthcare Provider Resources on Systemic inflammatory response syndrome	Symptoms of Systemic inflammatory response syndrome • Causes & Risk Factors for Systemic inflammatory response syndrome • Diagnostic studies for Systemic inflammatory response syndrome • Treatment of Systemic inflammatory response syndrome
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de:Systemisches inflammatorisches Response-Syndrom