The systemic inflammatory response syndrome: definitions and aetiology.

Systemic inflammatory response syndrome (SIRS) is the clinical expression of the action of complex intrinsic mediators of the acute phase reaction. SIRS can be precipitated by events such as infection, trauma, pancreatitis, and surgery. At times, SIRS can compromise the function of various organ systems resulting in Multiple Organ Dysfunction Syndrome (MODS). SIRS and MODS are graded expressions of the inflammation associated with acute illness. Mild forms are frequent in general wards for both medical and surgical patients but those with severe forms require intensive care. Clinicians should learn to identify SIRS in their patients at an early stage to determine the underlying cause and treatment before the SIRS progresses to a more severe form.

[1]  W. Knaus,et al.  The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults. , 1991, Chest.

[2]  S. Lemeshow,et al.  Mortality Probability Models (MPM II) based on an international cohort of intensive care unit patients. , 1993, JAMA.

[3]  P. Nyström,et al.  Outcome of intra-abdominal infection in pigs depends more on host responses than on microbiology. , 1993, The European journal of surgery = Acta chirurgica.

[4]  R. Bone,et al.  Toward a theory regarding the pathogenesis of the systemic inflammatory response syndrome: what we do and do not know about cytokine regulation. , 1996, Critical care medicine.

[5]  C. Dinarello,et al.  Cytokine Measurements in Septic Shock , 1993, Annals of Internal Medicine.

[6]  T. Clemmer,et al.  Sepsis syndrome: a valid clinical entity , 1989 .

[7]  S. Lowry,et al.  An overview of mortality risk prediction in sepsis. , 1995, Critical care medicine.

[8]  S. Lemeshow,et al.  A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. , 1993, JAMA.

[9]  R. Sauerwein,et al.  Cytokine Patterns in Patients After Major Vascular Surgery, Hemorrhagic Shock, and Severe Blunt Trauma Relation with Subsequent Adult Respiratory Distress Syndrome and Multiple Organ Failure , 1993, Annals of surgery.

[10]  W. Knaus,et al.  Evaluation of definitions for sepsis. , 1992, Chest.

[11]  A. Cerami,et al.  Tumor necrosis factor and endotoxin induce similar metabolic responses in human beings. , 1988, Surgery.

[12]  D. Pittet,et al.  The natural history of the systemic inflammatory response syndrome (SIRS). A prospective study. , 1995, JAMA.

[13]  R. Goris,et al.  Multiple-organ failure. Generalized autodestructive inflammation? , 1985, Archives of surgery.

[14]  C J Fisher,et al.  The clinical evaluation of new drugs for sepsis. A prospective study design based on survival analysis. , 1993, JAMA.

[15]  W. Knaus,et al.  APACHE II: a severity of disease classification system. , 1985 .

[16]  A. Whitehead,et al.  The major acute phase reactants: C-reactive protein, serum amyloid P component and serum amyloid A protein. , 1994, Immunology today.

[17]  J. Burke,et al.  The value and duration of defence reactions of the skin to the primary lodgement of bacteria. , 1957, British journal of experimental pathology.

[18]  F. Cerra,et al.  Multiple organ failure syndrome in the 1990s. Systemic inflammatory response and organ dysfunction. , 1994, JAMA.

[19]  W. Knaus,et al.  A comparison of risks and outcomes for patients with organ system failure: 1982-1990. , 1996, Critical care medicine.

[20]  C. Sprung,et al.  Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome. , 1995, Critical care medicine.

[21]  Roger C. Bone.  Definitions for Sepsis and Organ Failure , 1993 .

[22]  J. L. Gall,et al.  APACHE II--a severity of disease classification system. , 1986, Critical care medicine.

[23]  J. Marshall,et al.  Microbial infection and the septic response in critical surgical illness. Sepsis, not infection, determines outcome. , 1990, Archives of surgery.

[24]  R. Berg,et al.  Macrophage Elimination Increases Bacterial Translocation and Gut‐Origin Septicemia but Attenuates Symptoms and Mortality Rate in a Model of Systemic Inflammation , 1993, Annals of surgery.

[25]  W. Knaus,et al.  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. , 1992, Chest.

[26]  J. Gauldie,et al.  The acute phase response. , 1994, Immunology today.

[27]  R. Bone,et al.  Plasma Cytokine and Endotoxin Levels Correlate with Survival in Patients with the Sepsis Syndrome , 1993, Annals of Internal Medicine.

[28]  W. Knaus,et al.  Use of predicted risk of mortality to evaluate the efficacy of anticytokine therapy in sepsis. The rhIL-1ra Phase III Sepsis Syndrome Study Group. , 1996, Critical care medicine.