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Systemic inflammatory response syndrome

MedGen UID:
69303
•Concept ID:
C0242966
•
Disease or Syndrome
Synonyms: Inflammatory Response Syndrome, Systemic; Sepsis Syndrome; Sepsis Syndromes; Syndrome, Sepsis; Syndromes, Sepsis; Systemic Inflammatory Response Syndrome
SNOMED CT: SIRS - System inflammatory response syndrome (238149007); Systemic inflammatory response syndrome (238149007); Sepsis syndrome (238150007); Septic syndrome (238150007)

Definition

A generalized state of dysregulated inflammation induced by noninfectious processes. It is characterized by two or more of the following signs and symptoms: fever or hypothermia, increased heart rate, increased respiratory rate, and abnormal white blood cell count. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVSystemic inflammatory response syndrome

Professional guidelines

PubMed

International Consensus Criteria for Pediatric Sepsis and Septic Shock.
Schlapbach LJ, Watson RS, Sorce LR, Argent AC, Menon K, Hall MW, Akech S, Albers DJ, Alpern ER, Balamuth F, Bembea M, Biban P, Carrol ED, Chiotos K, Chisti MJ, DeWitt PE, Evans I, Flauzino de Oliveira C, Horvat CM, Inwald D, Ishimine P, Jaramillo-Bustamante JC, Levin M, Lodha R, Martin B, Nadel S, Nakagawa S, Peters MJ, Randolph AG, Ranjit S, Rebull MN, Russell S, Scott HF, de Souza DC, Tissieres P, Weiss SL, Wiens MO, Wynn JL, Kissoon N, Zimmerman JJ, Sanchez-Pinto LN, Bennett TD; Society of Critical Care Medicine Pediatric Sepsis Definition Task Force
JAMA 2024 Feb 27;331(8):665-674. doi: 10.1001/jama.2024.0179. PMID: 38245889Free PMC Article
American Gastroenterological Association Clinical Practice Update: Management of Pancreatic Necrosis.
Baron TH, DiMaio CJ, Wang AY, Morgan KA
Gastroenterology 2020 Jan;158(1):67-75.e1. Epub 2019 Aug 31 doi: 10.1053/j.gastro.2019.07.064. PMID: 31479658
Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine.
Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ
Chest 1992 Jun;101(6):1644-55. doi: 10.1378/chest.101.6.1644. PMID: 1303622

Recent clinical studies

Etiology

Lactated Ringers vs Normal Saline Resuscitation for Mild Acute Pancreatitis: A Randomized Trial.
Lee A, Ko C, Buitrago C, Hiramoto B, Hilson L, Buxbaum J; NS-LR Study Group
Gastroenterology 2021 Feb;160(3):955-957.e4. Epub 2020 Nov 4 doi: 10.1053/j.gastro.2020.10.044. PMID: 33159924
The inflammatory response to extracorporeal membrane oxygenation (ECMO): a review of the pathophysiology.
Millar JE, Fanning JP, McDonald CI, McAuley DF, Fraser JF
Crit Care 2016 Nov 28;20(1):387. doi: 10.1186/s13054-016-1570-4. PMID: 27890016Free PMC Article
Systemic inflammatory response syndrome (SIRS): where did it come from and is it still relevant today?
Balk RA
Virulence 2014 Jan 1;5(1):20-6. Epub 2013 Nov 13 doi: 10.4161/viru.27135. PMID: 24280933Free PMC Article
Hepatic dysfunction.
McCord KW, Webb CB
Vet Clin North Am Small Anim Pract 2011 Jul;41(4):745-58, vi. Epub 2011 May 23 doi: 10.1016/j.cvsm.2011.04.002. PMID: 21757090
Complications of massive transfusion.
Sihler KC, Napolitano LM
Chest 2010 Jan;137(1):209-20. doi: 10.1378/chest.09-0252. PMID: 20051407

Diagnosis

Multisystem Inflammatory Syndrome in Children (MIS-C).
Patel JM
Curr Allergy Asthma Rep 2022 May;22(5):53-60. Epub 2022 Mar 22 doi: 10.1007/s11882-022-01031-4. PMID: 35314921Free PMC Article
COVID-19 Pediatric Dermatology.
Neale H, Hawryluk EB
Dermatol Clin 2021 Oct;39(4):505-519. Epub 2021 May 31 doi: 10.1016/j.det.2021.05.012. PMID: 34556241Free PMC Article
Systemic Inflammatory Response Syndrome After Surgery: Mechanisms and Protection.
Margraf A, Ludwig N, Zarbock A, Rossaint J
Anesth Analg 2020 Dec;131(6):1693-1707. doi: 10.1213/ANE.0000000000005175. PMID: 33186158
Acute Inflammation and Metabolism.
Varela ML, Mogildea M, Moreno I, Lopes A
Inflammation 2018 Aug;41(4):1115-1127. doi: 10.1007/s10753-018-0739-1. PMID: 29404872
Hepatic dysfunction.
McCord KW, Webb CB
Vet Clin North Am Small Anim Pract 2011 Jul;41(4):745-58, vi. Epub 2011 May 23 doi: 10.1016/j.cvsm.2011.04.002. PMID: 21757090

Therapy

Clarithromycin for early anti-inflammatory responses in community-acquired pneumonia in Greece (ACCESS): a randomised, double-blind, placebo-controlled trial.
Giamarellos-Bourboulis EJ, Siampanos A, Bolanou A, Doulou S, Kakavoulis N, Tsiakos K, Katopodis S, Schinas G, Skorda L, Alexiou Z, Armenis K, Katsaounou P, Chrysos G, Masgala A, Poulakou G, Antonakos N, Safarika A, Kyprianou M, Dakou K, Gerakari S, Papanikolaou IC, Milionis H, Marangos M, Dalekos GN, Tzavara V, Akinosoglou K, Hatziaggelaki E, Sympardi S, Kontopoulou T, Mouktaroudi M, Papadopoulos A, Niederman MS
Lancet Respir Med 2024 Apr;12(4):294-304. Epub 2024 Jan 3 doi: 10.1016/S2213-2600(23)00412-5. PMID: 38184008
Lactated Ringers vs Normal Saline Resuscitation for Mild Acute Pancreatitis: A Randomized Trial.
Lee A, Ko C, Buitrago C, Hiramoto B, Hilson L, Buxbaum J; NS-LR Study Group
Gastroenterology 2021 Feb;160(3):955-957.e4. Epub 2020 Nov 4 doi: 10.1053/j.gastro.2020.10.044. PMID: 33159924
American Gastroenterological Association Clinical Practice Update: Management of Pancreatic Necrosis.
Baron TH, DiMaio CJ, Wang AY, Morgan KA
Gastroenterology 2020 Jan;158(1):67-75.e1. Epub 2019 Aug 31 doi: 10.1053/j.gastro.2019.07.064. PMID: 31479658
International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics.
Goldstein B, Giroir B, Randolph A; International Consensus Conference on Pediatric Sepsis
Pediatr Crit Care Med 2005 Jan;6(1):2-8. doi: 10.1097/01.PCC.0000149131.72248.E6. PMID: 15636651
Early goal-directed therapy in the treatment of severe sepsis and septic shock.
Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M; Early Goal-Directed Therapy Collaborative Group
N Engl J Med 2001 Nov 8;345(19):1368-77. doi: 10.1056/NEJMoa010307. PMID: 11794169

Prognosis

Association between the stress hyperglycemia ratio and 28-day all-cause mortality in critically ill patients with sepsis: a retrospective cohort study and predictive model establishment based on machine learning.
Yan F, Chen X, Quan X, Wang L, Wei X, Zhu J
Cardiovasc Diabetol 2024 May 9;23(1):163. doi: 10.1186/s12933-024-02265-4. PMID: 38725059Free PMC Article
Multisystem inflammatory syndrome (MIS-C): a systematic review and meta-analysis of clinical characteristics, treatment, and outcomes.
Santos MO, Gonçalves LC, Silva PAN, Moreira ALE, Ito CRM, Peixoto FAO, Wastowski IJ, Carneiro LC, Avelino MAG
J Pediatr (Rio J) 2022 Jul-Aug;98(4):338-349. Epub 2021 Dec 3 doi: 10.1016/j.jped.2021.08.006. PMID: 34863701Free PMC Article
SIRS or not SIRS: Is that the infection? A critical review of the sepsis definition criteria.
Jaramillo-Bustamante JC, Piñeres-Olave BE, González-Dambrauskas S
Bol Med Hosp Infant Mex 2020;77(6):293-302. doi: 10.24875/BMHIM.20000202. PMID: 33186343
Early, Nurse-Directed Sepsis Care.
Ferguson A, Coates DE, Osborn S, Blackmore CC, Williams B
Am J Nurs 2019 Jan;119(1):52-58. doi: 10.1097/01.NAJ.0000552614.89028.d6. PMID: 30589710
Complications of massive transfusion.
Sihler KC, Napolitano LM
Chest 2010 Jan;137(1):209-20. doi: 10.1378/chest.09-0252. PMID: 20051407

Clinical prediction guides

Association between the stress hyperglycemia ratio and 28-day all-cause mortality in critically ill patients with sepsis: a retrospective cohort study and predictive model establishment based on machine learning.
Yan F, Chen X, Quan X, Wang L, Wei X, Zhu J
Cardiovasc Diabetol 2024 May 9;23(1):163. doi: 10.1186/s12933-024-02265-4. PMID: 38725059Free PMC Article
Clinical usefulness of scoring systems to predict severe acute pancreatitis: A systematic review and meta-analysis with pre and post-test probability assessment.
Capurso G, Ponz de Leon Pisani R, Lauri G, Archibugi L, Hegyi P, Papachristou GI, Pandanaboyana S, Maisonneuve P, Arcidiacono PG, de-Madaria E
United European Gastroenterol J 2023 Nov;11(9):825-836. Epub 2023 Sep 27 doi: 10.1002/ueg2.12464. PMID: 37755341Free PMC Article
External Validation of a Widely Implemented Proprietary Sepsis Prediction Model in Hospitalized Patients.
Wong A, Otles E, Donnelly JP, Krumm A, McCullough J, DeTroyer-Cooley O, Pestrue J, Phillips M, Konye J, Penoza C, Ghous M, Singh K
JAMA Intern Med 2021 Aug 1;181(8):1065-1070. doi: 10.1001/jamainternmed.2021.2626. PMID: 34152373Free PMC Article
A Comparison of the Quick-SOFA and Systemic Inflammatory Response Syndrome Criteria for the Diagnosis of Sepsis and Prediction of Mortality: A Systematic Review and Meta-Analysis.
Serafim R, Gomes JA, Salluh J, Póvoa P
Chest 2018 Mar;153(3):646-655. Epub 2017 Dec 28 doi: 10.1016/j.chest.2017.12.015. PMID: 29289687
Quick Sepsis-related Organ Failure Assessment, Systemic Inflammatory Response Syndrome, and Early Warning Scores for Detecting Clinical Deterioration in Infected Patients outside the Intensive Care Unit.
Churpek MM, Snyder A, Han X, Sokol S, Pettit N, Howell MD, Edelson DP
Am J Respir Crit Care Med 2017 Apr 1;195(7):906-911. doi: 10.1164/rccm.201604-0854OC. PMID: 27649072Free PMC Article

Recent systematic reviews

SIRS, SOFA, qSOFA, and NEWS in the diagnosis of sepsis and prediction of adverse outcomes: a systematic review and meta-analysis.
Qiu X, Lei YP, Zhou RX
Expert Rev Anti Infect Ther 2023 Jul-Dec;21(8):891-900. Epub 2023 Jul 18 doi: 10.1080/14787210.2023.2237192. PMID: 37450490
Antimicrobial treatment of Corynebacterium striatum invasive infections: a systematic review.
Milosavljevic MN, Milosavljevic JZ, Kocovic AG, Stefanovic SM, Jankovic SM, Djesevic M, Milentijevic MN
Rev Inst Med Trop Sao Paulo 2021;63:e49. Epub 2021 Jun 18 doi: 10.1590/S1678-9946202163049. PMID: 34161555Free PMC Article
Multisystem inflammatory syndrome in children related to COVID-19: a systematic review.
Hoste L, Van Paemel R, Haerynck F
Eur J Pediatr 2021 Jul;180(7):2019-2034. Epub 2021 Feb 18 doi: 10.1007/s00431-021-03993-5. PMID: 33599835Free PMC Article
The diagnostic accuracy of procalcitonin and C-reactive protein for sepsis: A systematic review and meta-analysis.
Tan M, Lu Y, Jiang H, Zhang L
J Cell Biochem 2019 Apr;120(4):5852-5859. Epub 2018 Nov 11 doi: 10.1002/jcb.27870. PMID: 30417415
A Comparison of the Quick-SOFA and Systemic Inflammatory Response Syndrome Criteria for the Diagnosis of Sepsis and Prediction of Mortality: A Systematic Review and Meta-Analysis.
Serafim R, Gomes JA, Salluh J, Póvoa P
Chest 2018 Mar;153(3):646-655. Epub 2017 Dec 28 doi: 10.1016/j.chest.2017.12.015. PMID: 29289687

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