systemic inflammatory response syndrome

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. ^ ^{a b} 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. ^ ^{a b} 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
• The ICU Book by Marino
• 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.

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