SYSTEMIC INFLAMMATORY

RESPONSE SYNDROME(SIRS)

Vibha khatri
Roll no-69
SIRS is a systemic manifestation of inflammation due
to variety of causes like infection ,pancreatitis,
polytrauma,burns,transfusion reaction and
malignancy.
It is categorised into two types :
1) Infectious
2) Non infectious
 INFECTIOUS CAUSES NON INFECTIOUS CAUSES

Bacteremia Burns
Bacterial sepsis Hemorrhage
Influenza Trauma
UTI Hypovolaemia
• Hyperthermia (>38°C) or hypothermia(<36°C)
• Tachycardia (pulse>90/minute)
• Tachypnoea(>20/minute)
• Total white cell count >12,000/cu mm or count <4,000/cu
mm
It is a final common pathway in shock due to any cause
(trauma,sepsis,burns)where there is a
- failure of inflammatory localisation with vasodilation
- increased endothelial permeability with damage
- thrombosis
- leucocyte migration and activation
• Pathophysiology
Toxins or endotoxins from organisms like E.coli,
Klebsiella,Pseudomonas and proteus

Inflammation ,cellular activation of macrophages,

neutophils,monocyte
 Release of cytokine,free radicals

Chemotaxis of cells,endothelial injury,

altered coagulation cascade-SIRS

Reversible hyperdynamic warm stage of septic shock with

fever,tachycardia,tachypnoea
 Severe circulatory failure with MODS with DIC

Hypodynamic,irreversible cold stage of septic shock

 SIRS

Sepsis

Severe sepsis

Septic shock
Sepsis-It is a life threatening organ dysfunction caused by a
dysregulated host response to infection identified by the presense of
2 or more SOFA points (sequential [sepsis related] organ failure
assessment).
Quick SOFA score is also used –
• Low BP(<100mmhg)
• Increased respiratory rate(>22/minute)
• Altered mentation-GCS<13
Magnitude of infection is quantified as:
• Mild sepsis- fever,tachycardia,leucocytosis.
• Severe sepsis- low tissue perfusion with organ dysfunction (lactic
acidosis,dysfunction of liver,kidney,lungs).
• Septic shock- systemic hypotension (BP<90mmhg),severe organ
dysfunction ,mal distribution of blood flow,shunting of micro
circulation.
 Potential complications of SIRS
•Anemia
•Deep venous thrombosis
•DIC
•GI bleeding
•Renal failure
•Respiratory failure
•Electrolyte abnormalities
•Cardiorespiratory decompensation
Management
Laboratory testing – complete blood count
Sputum culture
Urine culture
Blood culture
Spinal fluid analysis
Lactic acid level
Cardiac enzymes ani EKG
Radiographic testing –Chest radiograph
Abdominal radiograph
Soft tissue radiograph
CT of abdomen and pelvis
CT of chest
CT or MRI of brain and soft tissues
Treatment
• Correction of fluid and electrolytes
• Appropriate antibiotics – third generation cephalosporins/
aminoglycosides
• Treat the cause or focus
• Critical care,oxygen,ventilator support ,maintain BP,urine output
Thank you