Systemic inflammatory response syndrome (SIRS)

Balk, R.A.

doi:10.4161/viru.27135

Cited by 261 publications

(120 citation statements)

References 44 publications

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“…The SIRS represents a non-specific complex reaction of the organism to severe damage whether it is an infection, mechanical or thermal injury, pancreatitis etc. [13]. For SIRS diagnosis more than 2 criteria should be met: body temperature > 38 °C or < 36 °C; heart rate > 90/min; respiratory rate > 20/min or PaCO 2 < 32 mm Hg (4.3 kPa); white blood cell count > 12 000/mm 3 or < 4000/mm 3 or > 10% immature bands [6].…”

Section: Sepsis Sae and Models Of Sepsismentioning

confidence: 99%

Astroglia in Sepsis Associated Encephalopathy

Shulyatnikova

Verkhratsky

2019

Neurochem Res

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Cellular pathophysiology of sepsis associated encephalopathy (SAE) remains poorly characterised. Brain pathology in SAE, which is manifested by impaired perception, consciousness and cognition, results from multifactorial events, including high levels of systemic cytokines, microbial components and endotoxins, which all damage the brain barriers, instigate neuroinflammation and cause homeostatic failure. Astrocytes, being the principal homeostatic cells of the central nervous system contribute to the brain defence against infection. Forming multifunctional anatomical barriers, astroglial cells maintain brain-systemic interfaces and restrict the damage to the nervous tissue. Astrocytes detect, produce and integrate inflammatory signals between immune cells and cells of brain parenchyma, thus regulating brain immune response. In SAE astrocytes are present in both reactive and astrogliopathic states; balance between these states define evolution of pathology and neurological outcomes. In humans pathophysiology of SAE is complicated by frequent presence of comorbidities, as well as age-related remodelling of the brain tissue with senescence of astroglia; these confounding factors further impact upon SAE progression and neurological deficits.

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Section: Sepsis Sae and Models Of Sepsismentioning

confidence: 99%

Astroglia in Sepsis Associated Encephalopathy

Shulyatnikova

Verkhratsky

2019

Neurochem Res

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“…Over the last two decades, many noted the limitations of SIRS criteria, 3-5 prompting calls to revisit the definition of sepsis. 6,7 …”

Section: Introductionmentioning

confidence: 99%

An Emergency Department Validation of the SEP-3 Sepsis and Septic Shock Definitions and Comparison With 1992 Consensus Definitions

Henning

Puskarich

Self

et al. 2017

Annals of Emergency Medicine

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Background The Third International Consensus Definitions Task Force (SEP-3) proposed revised criteria defining sepsis and septic shock. We sought to: 1) evaluate the performance of the SEP-3 definitions for prediction of in-hospital mortality in an Emergency Department (ED) population, and 2) compare the performance of the SEP-3 definitions to the previous definitions. Methods Secondary analysis of three prospectively collected, observational cohorts of infected ED subjects ≥18 years old. The primary outcome was all-cause in-hospital mortality. Based on the SEP-3 definitions, we calculated test characteristics of sepsis (qSOFA score ≥2) and septic shock (vasopressor dependence plus lactate >2.0 mmol/L) for mortality and compared them to the original 1992 consensus definitions. Results We identified 7,754 ED patients with suspected infection overall; 117 had no documented mental status evaluation, leaving 7,637 patients included in the analysis. The mortality rate for the overall population was 4.4% (95% CI: 3.9 – 4.9%). The mortality rate for patients with qSOFA ≥2 was 14.2% (12.2 – 16.2%), with a sensitivity of 52% (46 – 57%) and specificity of 86% (85 – 87%) to predict mortality. The original SIRS-based 1992 consensus sepsis definition had a 6.8% (6.0 – 7.7%) mortality rate, sensitivity of 83% (79 – 87%) and specificity of 50% (49 – 51%). The SEP-3 septic shock mortality was 23% (16 – 30%), with a sensitivity of 12%(11 –13%) and specificity of 98.4% (98.1 – 98.7%). The original 1992 septic shock definition had a 22% (17 – 27%) mortality rate, sensitivity of 23% (18 – 28%), and specificity of 96.6% (96.2 – 97.0%). Conclusion Both the new SEP-3 and original sepsis definitions stratify ED patients at risk for mortality, albeit with differing performances. In terms of mortality prediction, the SEP-3 definitions had improved specificity, but at the cost of sensitivity. Use of either approach requires a clearly intended target – more sensitivity versus specificity.

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“…The concept of SIRS was introduced in the early nineties at the American College of Chest Physicians and Society of Critical Care consensus conference 1. The goal of the conference was to introduce simple definitions for SIRS, sepsis, severe sepsis, septic shock, and multiple organ dysfunction, using clinical variables that would be easy to measure and accessible to any clinician 2. These simple definitions would ensure uniformity in the terminology used in publications and across clinicians and lead to early identification of patients at risk for critical illness and sepsis that could benefit from early therapeutic intervention.…”

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confidence: 99%

Prognostic Value and Development of a Scoring System in Horses With Systemic Inflammatory Response Syndrome

Roy

Kwong

Lambert

et al. 2017

Veterinary Internal Medicne

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BackgroundDespite its widespread use in equine medicine, the clinical value of the systemic inflammatory response syndrome (SIRS) concept in horses remains unknown.ObjectivesTo study the prognostic value of measures of SIRS in horses and identify the best model of severe SIRS to predict outcome.AnimalsA total of 479 consecutive adult horse emergency admissions to a private primary referral practice.MethodsProspective observational study. All adult horses admitted for emergency treatment over the study period were included. Multivariate logistic regression and stepwise model selection were used.ResultsEach of the 4 SIRS criteria was associated with outcome in this population. Thirty‐one percent of emergency cases had 2 or more abnormal SIRS criteria on admission and were defined as SIRS cases. SIRS was associated with increased odds of death (odds ratio [OR] = 8.22; 95% CI, 4.61–15.18; P < .001), an effect mainly found for acute gastrointestinal cases. SIRS cases were assigned a SIRS score of 2, 3, or 4, according to the number of abnormal SIRS criteria fulfilled on admission, and SIRS3 and SIRS4 cases had increased odds of death compared to SIRS2 cases (OR = 4.45; 95% CI, 1.78–11.15; P = .002). A model of severe SIRS including the SIRS score, blood lactate concentration, and color of the mucous membranes best predicted outcome in this population of horses.Conclusions and Clinical ImportanceSystemic inflammatory response syndrome is associated with an increased risk of death in adult horses presenting with acute gastrointestinal illnesses. The model of severe SIRS proposed in this study could be used to assess the status and prognosis of adult equine emergency admissions.

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Systemic inflammatory response syndrome (SIRS)

Cited by 261 publications

References 44 publications

Astroglia in Sepsis Associated Encephalopathy

Astroglia in Sepsis Associated Encephalopathy

An Emergency Department Validation of the SEP-3 Sepsis and Septic Shock Definitions and Comparison With 1992 Consensus Definitions

Prognostic Value and Development of a Scoring System in Horses With Systemic Inflammatory Response Syndrome

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