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

Inflammation is an essential component of host defense and serves a very strongly positive survival function in suppressing and then eliminating local infection and tissue injury. It is only when a localized aggressive injury process gains access to the whole body through the blood stream and lymphatics that SIRS develops. Independent of the etiology, SIRS has the same pathophysiologic properties, with minor differences in inciting cascades. Many consider the syndrome a self-defense mechanism.

Women tend to have less inflammation from the same degree of proinflammatory stimuli due to the mitigating aspects of estrogen. The reasons for this are not completely known, but estrogen sustains adrenergic receptor activity in inflammation, when, in its absence, adrenergic receptor downregulation occurs. Thus, premenopausal women tend to have less vasoplegia and respond more vigorously to resuscitation efforts. This equates to women having a 10-year age benefit over men.

The true incidence of SIRS is unknown but probably very high, owing to the nonspecific nature of its definition. Not all patients with SIRS require hospitalization or have diseases that progress to serious illness. Indeed, patients with a seasonal head cold due to rhinovirus usually fulfill the criteria for SIRS. Because SIRS criteria are nonspecific and occur in patients who present with conditions ranging from influenza to cardiovascular collapse associated with severe pancreatitis, any incidence figures must be stratified based on SIRS severity.

For more on SIRS, read here.

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