Systemic inflammatory response syndrome SIRS

In rare cases of a systemic release, kinins have the potential to cause severe hypotension. Uncontrolled activation of the contact system (Fig. 3) is thought to trigger a massive formation of kinins under certain pathological conditions [3]. For instance, this situation is seen in patients with underlying diseases such as systemic inflammatory response syndrome (SIRS) due to sepsis or trauma. SIRS progression is accompanied by depletion of contact system factors and low levels of H-kininogen and plasma kallikrein are indicative of a... 

Sepsis is a continuum of physiologic stages characterized by infection, systemic inflammation, and hypoperfusion with widespread tissue injury.1 The American College of Chest Physicians and the Society of Critical Care Medicine developed definitions to utilize for sepsis (Table 79—l).2 They provide physiologic parameters categorizing patients as having bacteremia, infection, systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, septic shock, or multiple-organ-dysfunction syndrome (MODS).2 Standardized definitions have been developed for infections in critically ill patients.3... 

Pathological findings frequently observed in organs of patients who have died of sepsis include disseminated intravascular coagulation (DIC), manifested as diffuse thrombotic occlusions in the entire microvascular system, associated with alterations in the hemostatic mechanism and clinical signs of hemorrhagic diathesis. Many observations indicate that DIC contributes to the major symptoms of the systemic inflammatory response syndrome (SIRS), which frequently complicate sepsis (HI, H2, H3, T6). 

D5. Darville, T Giroir, B and Jacobs, R., The systemic inflammatory response syndrome (SIRS) immunology and potential immunotherapy. Infection 21,279-290 (1993). 

Sepsis What the pathogen does to the patient. For example, a patient with gram-negative bacillary pneumonia may receive a perfectly adequate course of antibiotic chemotherapy, only to succumb to systemic inflammatory response syndrome (SIRS), an exaggerated and counterproductive release of inflammatory cytokines. 

Noradrenaline is used to treat shock-like conditions associated with peripheral vasodilatation, e.g. sepsis, systemic inflammatory response syndrome (SIRS), neurogenic shock. The rationale of its use in sepsis and SIRS is to counteract the vasodilatory effects of nitric oxide. Following the surgical removal of phaeochromocytoma and similar tumours, noradrenaline is often given to maintain blood pressure in the initial period. During and after cardiac surgery, it may be used to optimise haemodynamic parameters in combination with other drugs, such as phosphodi-esterase inhibitors. Dose... 

Rangel-Frausto MS, Pittet D, Costigan M, Hwang T, Davis CS, Wenzel RP (1995) The natural history of the systemic inflammatory response syndrome (SIRS). A prospective study. JAMA 273(2) 117-123... 

H7. Hietaranta, A., Kemppainen, E., Puolakkainen, P., Sainio, V., Haapiainen, R., Peuravuori, H., Kivilaakso, E., and Nevalainen, T., Extracellular phospholipases A2 in relation to systemic inflammatory response syndrome (SIRS) and systemic complications in severe acute pancreatitis. Pancreas 18, 385-391 (1999). 

SYSTEMIC INFLAMMATORY RESPONSE SYNDROME (SIRS) SHOCK STATE... 

Inflammatory Conditions. Many conditions associated with inflammation and increased oxidative stress could be influenced by selenium status. Positive effects from supplementation studies in arthritis and in pancreatitis have been reported. Low sermn selenium values are found in asthma, and some limited clinical trial studies show benefits firom supplementation." In a small trial in patients in intensive care with systemic inflammatory response syndrome (SIRS), high-dose selenium supplements over 9 days were associated with reduced incidence of renal failure and reduced mortality in the most severely fll. ... 

The criteria for the new terms provide specific physiologic variables that can be used to categorize a patient as having bacteremia, systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, septic shock, or multiple-organ-dysfunction syndrome (MODS),... 

Sepsis—The systemic inflammatory response syndrome (SIRS) secondary to infection. See also Systemic inflammatory response syndrome. 

Systemic inflammatory response syndrome (SIRS)—Systemic inflammatory response to a variety of clinical insults, which can be of infectious or noninfectious etiology. 

Liano F, Junco E, Pascual J, Madero R, Verde E The spectrum of acute renal failure in the intensive care unit compared with that seen in other settings. The Madrid Acute Renal Failure Study Group. Kidney Int SuppI 66 S16-S24, 1998 Rangel-Frausto MS, Pittet D, Costigan M, Hwang T, Davis CS, Wenzel RP The natural history of the systemic inflammatory response syndrome (SIRS). A prospective study. JAMA 273 117-123, 1995... 

The finding that hemoperfusion through the polymeric BetaSorb column effectively removes several middle-molecular-weight toxic proteins and that such toxins and cytokines are heavily involved in the systemic inflammatory response syndrome (SIRS) have stimulated extensive preclinical studies to demonstrate the wider utility of the hemoperfusion procedure. Winchester et al. [365] list 24 cytokines and other protein and glycoprotein molecules in the molecular weight range of 4—llOkDa that are implicated in SIRS. In addition to ESRD, SIRS is caused by various other health problems, such as acute renal failure (350,000 cases per year in the USA), cardiopulmonary bypass surgery (1.5 million/year), and sepsis. 

Criteria for Systemic Inflammatory Response Syndrome (SIRS) are fulfilled if two of the following four criteria are met (American College of Chest Physicians, 1992)... 

A second study examined a model of systemic inflammatory response syndrome (SIRS) with lung injury secondary to acute caerulin-induced pancreatitis. Whereas the initial pancreatic injury was not blunted, the lung injury was diminished in CCR-1 (-/-) mice. Thus, both of these studies indicated that in the mouse, CCRl is an important PMN neutrophil agonist, and cautioned against extrapolating between species concerning chemokine function. 

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