Canis ISSN: 2398-2942

Systemic inflammatory response syndrome (SIRS)

Contributor(s): John Dodam, Elisa Mazzaferro

Introduction

  • SIRS is a condition associated with activation of multiple inflammatory pathways that often results in severe organ dysfunction and death.
  • The malignant inflammatory cascade can be triggered by a multitude of specific conditions including trauma, thermal tissue damage, infectious disease, toxins, or inflammation.
  • Progression of SIRS results in multiple organ dysfunction Multiple organ dysfunction syndrome (MODS) , and can cause death. Indeed, multiple organ dysfunction is an important cause of death in human ICU patients and may have a mortality rate of 40-90%. Mortality is probably similar in veterinary patients.
  • Extensive research is ongoing to delineate the pathophysiology of SIRS. Identification of the molecular and cellular triggers that give rise to organ system dysfunction may lead to specific and effective therapy for the syndrome.
  • The exact incidence of SIRS is not known in the veterinary patient population.
  • Burns Skin: burn / scald , sepsis Shock: septic and bacteremia are probably the most common causes of SIRS in veterinary patients. Pyothorax Pyothorax , septic peritonitis Peritonitis , gastroenteritis, pneumonia Lung: bacterial pneumonia , endocarditis Endocarditis: bacterial , pyelonephritis Kidney: pyelonephritis , osteomyelitis Osteomyelitis , pyometra Pyometra , and bite wounds are all conditions that can lead to sepsis in canine patients.
  • In addition, the use of invasive monitoring, diagnostic, and therapeutic procedures may increase risk for infection. Because veterinarians are becoming more sophisticated and are using invasive diagnostic and therapeutic techniques more frequently, it is reasonable to assume that the incidence of SIRS and sepsis may increase in the hospitalized patient population.

Pathogenesis

Etiology

  • SIRS is caused by activation of a systemic inflammatory response that involves the biosynthesis of cytokines, lipid mediators of inflammation, and reactive oxygen molecules. Initiation of the coagulation cascade and the production of acute phase reactants may also play a role in the development of SIRS.

Predisposing factors

General

Pathophysiology

  • SIRS is secondary to a variety of insults that result in a systemic inflammatory response.
  • SIRS is the result of the activation of a variety of inflammatory pathways. The dramatic and generalized nature of the response is what results in dysfunction. It is speculated that each component of the response is designed to be protective when the response is local in nature. The production of cytokines (tumor necrosis factor, interleukins 1 and 6, interferons), lipid mediators of inflammation (platelet activating factor, prostaglandins, leukotrienes), and activation of the coagulation cascade, coupled with the activation of endothelial cells and numerous immune cells results in multiple organ dysfunction and altered immune response.
  • Sepsis Shock: septic is commonly associated with SIRS in veterinary species.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

Other sources of information

  • Kirby R (1995) Septic shock. In: Kirks Current Veterinary Therapy XII Small Animal Practice. Bonagura J D, Kirk R W, eds. WB Saunders Company. pp. 139-146.


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