Fast Five Quiz: How Much Do You Know About Systemic Inflammatory Response Syndrome?

Michael R. Pinksy, MD, CM, Dr(HC), FCCP, MCCM

Disclosures

February 12, 2018

In 1992, the American College of Chest Physicians and the Society of Critical Care Medicine introduced definitions for systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, septic shock, and multiple organ dysfunction syndrome. The idea behind defining SIRS was to define a clinical response to a nonspecific insult of either infectious or noninfectious origin. SIRS is defined as two or more of the following variables:

  • Fever of more than 100.4°F (38°C) or less than 96.8°F (36°C)

  • Heart rate of more than 90 beats/min

  • Respiratory rate of more than 20 breaths/min or arterial carbon dioxide tension of less than 32 mm Hg

  • Abnormal white blood cell count (> 12,000/µL or < 4000/µL or > 10% immature [band] forms)

SIRS is nonspecific and can be caused by ischemia, inflammation, trauma, infection, or several insults combined. Thus, SIRS is not always related to infection. Although sepsis has diverged from SIRS criteria for diagnosis and management in recent years, focusing more on infectious etiologies, the pathophysiologic processes present in sepsis and noninfectious SIRS are remarkably similar, making a discussion of SIRS in critical illness appropriate.

Are you familiar with the background and presentation of SIRS, as well as key aspects of workup and treatment? Test yourself with this quick quiz.

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