Systemic inflammatory response syndrome
What is it?
Systemic inflammatory response syndrome (SIRS) is an inflammatory state affecting the whole body. It is the body's response to an infectious or noninfectious insult. Although the definition of SIRS refers to it as an "inflammatory" response, it actually has pro- and anti-inflammatory components.
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Systemic inflammatory response syndrome.
Additional names
This group contains additional names:
- SIRS
Signs & symptoms
To be diagnosed with SIRS , you must have a probable or confirmed infection and all of the following signs:
* Change in mental status
* Systolic blood pressure- the first number in a blood pressure reading- less than or equal to 100 millimeters of mercury (mm Hg)
* Respiratory rate higher than or equal to 22 breaths a minute
Diagnosis
Manifestations of SIRS include, but are not limited to:
* Body temperature less than 36 C (96.8 F) or greater than 38 C (100.4 F)
* Heart rate greater than 90 beats per minute
* Tachypnea (high respiratory rate), with greater than 20 breaths per minute; or, an arterial partial pressure of carbon dioxide less than 4.3 kPa (32 mmHg)
* White blood cell count less than 4000 or greater than 12,000 (12 x 109 cells/L); or the presence of greater than 10% immature neutrophils (band forms). Band forms greater than 3% is called bandemia or a "left-shift".
When two or more of these criteria are met with or without evidence of infection, patients may be diagnosed with "SIRS". Patients with SIRS and acute organ dysfunction may be termed severe SIRS".
Treatment
Generally, the treatment for SIRS is directed towards the underlying problem or inciting cause (i.e. adequate fluid replacement for hypovolemia, IVF/NPO for pancreatitis, epinephrine/steroids/diphenhydramine for anaphylaxis). Selenium, glutamine, and eicosapentaenoic acid have shown effectiveness in improving symptoms in clinical trials.Other antioxidants such as vitamin E may be helpful as well.
Septic treatment protocol and diagnostic tools have been created due to the potentially severe outcome septic shock. For example, the SIRS criteria were created as mentioned above to be extremely sensitive in suggesting which patients may have sepsis. However, these rules lack specificity, i.e. not a true diagnosis of the condition, but rather a suggestion to take necessary precautions. The SIRS criteria are guidelines set in place to ensure septic patients receive care as early as possible.
In cases caused by an implanted mesh, removal (explantation) of the polypropylene surgical mesh implant may be indicated.
☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.
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