Systemic inflammatory response syndrome 850969 221428317 2008-06-24T13:26:07Z Nescio 343981 [[WP:UNDO|Undid]] revision 221138671 by [[Special:Contributions/170.134.57.9|170.134.57.9]] ([[User talk:170.134.57.9|talk]]) {{Infobox_Disease | Name = {{PAGENAME}} | Image = | Caption = | DiseasesDB = | ICD10 = | ICD9 = {{ICD9|995.90}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeshID = }} 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 medical emergency. ==Definition of SIRS== Criteria for SIRS were agreed upon 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> * [[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<sub>a</sub>CO<sub>2</sub> < 4.3 kPa (32 mm Hg) * [[White blood cell]] count [[Leukopenia|< 4000 cells/mm³]] or [[Leukocytosis|> 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. ==Difference between SIRS and sepsis== SIRS due to a suspected or proven infection is called [[sepsis]]. Simply stated: :''SIRS + infection = sepsis'' <ref name=intensive_care/><ref name=marino/> ==Complications of SIRS== SIRS can result in the [[multiple organ dysfunction syndrome]]. <br />[[Hypotension]] related to vessel dilation <br />Hypovolemic [[shock (medical)|shock]] ==Causes of SIRS== * Severe [[Physical trauma|trauma]] * Surgery, complication of * [[Adrenal insufficiency]] * [[Pulmonary embolism]] * Complicated [[aortic aneurysm]] * [[Myocardial infarction]] * [[Hemorrhage]] * [[Cardiac tamponade]] * [[Anaphylaxis]] * Drug overdose * [[burn (injury)|Burns]] * [[Acute pancreatitis]] * [[Immunodeficiency]] (such as [[AIDS]]<ref>Santhanam S, Tolan RW. Sepsis. eMedicine.com, URL: http://www.emedicine.com/ped/topic3033.htm Accessed on Mar 12, 2006.</ref>) ==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 (medical)|Shock]] * [[Septic shock]] ==References== {{reflist}} ==External links== * [http://www.merck.com/mrkshared/mmanual/section13/chapter156/156a.jsp Bacteremia and Septic Shock] ([[Merck Manual]]) - explains the usage of the terms ''bacteremia'', ''septic shock'', ''sepsis'' and ''septicemia''. [[Category:Intensive care medicine]] [[Category:Immune system disorders]] [[Category:Causes of death]] [[de:Systemisches inflammatorisches Response-Syndrom]] [[es:Síndrome de respuesta inflamatoria sistémica]] [[fr:Syndrome de réponse inflammatoire systémique]] [[hr:Sindrom sustavna upalnog odgovora]] [[it:Sindrome da Risposta Infiammatoria Sistemica]] [[pl:SIRS]] [[pt:Síndrome da resposta inflamatória sistêmica]] [[sv:Systemiskt inflammationsresponssyndrom]] [[vi:Hội chứng đáp ứng viêm hệ thống]]