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'''For more information about [[sepsis spectrum syndromes]], [[sepsis|click here]].'''
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In [[medicine]], '''systemic inflammatory response syndrome''' ('''SIRS''') is an [[inflammation|inflammatory state]] of the whole body (the "system") without a proven source of [[infection]]. It is a serious medical condition.
In [[medicine]], '''systemic inflammatory response syndrome''' ('''SIRS''') is an [[inflammation|inflammatory state]] of the whole body (the "system") without a proven source of [[infection]]. It is a serious medical condition.


==Definition of SIRS==
==Definition of SIRS <ref name="pmid18158437">{{cite journal |author=Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R, Calandra T, Dhainaut JF, Gerlach H, Harvey M, Marini JJ, Marshall J, Ranieri M, Ramsay G, Sevransky J, Thompson BT, Townsend S, Vender JS, Zimmerman JL, Vincent JL |title=Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008 |journal=[[Critical Care Medicine]] |volume=36 |issue=1 |pages=296–327 |year=2008 |month=January |pmid=18158437 |doi=10.1097/01.CCM.0000298158.12101.41 |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0090-3493&volume=36&issue=1&spage=296 |accessdate=2012-09-16}}</ref>, <ref>Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992 Jun;101(6):1644-55. PMID 1303622.</ref>==
Criteria for SIRS were agreed in 1992.<ref>{{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=}}</ref> SIRS can be diagnosed when two or more of the following are present<ref name=intensive_care>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].</ref><ref name=marino>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].</ref><ref>Sharma S, Steven M. Septic Shock. eMedicine.com, URL: http://www.emedicine.com/MED/topic2101.htm Accessed on Nov 20, 2005.</ref><ref name=tslotou>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].</ref>:
Criteria for SIRS were agreed in 1992.<ref>{{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=}}</ref> SIRS can be diagnosed when two or more of the following are present<ref name=tslotou>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].</ref>:
* [[Heart rate]] > 90 beats per minute
* [[Heart rate]] > 90 beats per minute
* Body temperature < 36 or > 38°C
* [[Temperature]] < 36 (96.8 °F) or > 38 °C (100.4 °F)
* [[Tachypnea]] (high respiratory rate) > 20 breaths per minute or, on [[blood gas]], a P<sub>a</sub>CO<sub>2</sub> < 4.3 kPa (32 mm Hg)
* [[Tachypnea]] > 20 breaths per minute or, on [[blood gas]], a P<sub>a</sub>CO<sub>2</sub> < 32 mm Hg
* [[White blood cell]] count < 4000 cells/mm³ or > 12000 cells/mm³ (< 4 x 10<sup>9</sup> or > 12 x 10<sup>9</sup> cells/L), or the presence of greater than 10% immature neutrophils.
* [[White blood cell]] count < 4000 cells/mm³ or > 12000 cells/mm³ (< 4 x 10<sup>9</sup> or > 12 x 10<sup>9</sup> cells/[[litre|L]]), or > 10% band forms (immature white blood cells / bandemia).


==Difference between SIRS and sepsis==
==Difference between SIRS and sepsis==
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Simply stated:  
Simply stated:  
:''SIRS + infection = sepsis'' <ref name=intensive_care/><ref name=marino/>
:'''SIRS + infection = sepsis'''


==Complications of SIRS==
==Complications of SIRS==

Latest revision as of 15:04, 2 June 2017

For more information about sepsis spectrum syndromes, click here.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: SIRS

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 [1], [2]

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

  • Heart rate > 90 beats per minute
  • Temperature < 36 (96.8 °F) or > 38 °C (100.4 °F)
  • Tachypnea > 20 breaths per minute or, on blood gas, a PaCO2 < 32 mm Hg
  • White blood cell count < 4000 cells/mm³ or > 12000 cells/mm³ (< 4 x 109 or > 12 x 109 cells/L), or > 10% band forms (immature white blood cells / bandemia).

Difference between SIRS and sepsis

SIRS with a suspected or proven infection is called sepsis.

Simply stated:

SIRS + infection = sepsis

Complications of SIRS

SIRS can result in the multiple organ dysfunction syndrome.

Causes of SIRS

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

References

  1. Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R, Calandra T, Dhainaut JF, Gerlach H, Harvey M, Marini JJ, Marshall J, Ranieri M, Ramsay G, Sevransky J, Thompson BT, Townsend S, Vender JS, Zimmerman JL, Vincent JL (2008). "Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008". Critical Care Medicine. 36 (1): 296–327. doi:10.1097/01.CCM.0000298158.12101.41. PMID 18158437. Retrieved 2012-09-16. Unknown parameter |month= ignored (help)
  2. Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992 Jun;101(6):1644-55. PMID 1303622.
  3. "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. 1992. PMID 1597042.
  4. 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.
  5. Santhanam S, Tolan RW. Sepsis. eMedicine.com, URL: http://www.emedicine.com/ped/topic3033.htm Accessed on Mar 12, 2006.

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