SIRS
and Sepsis
According
to Kleinpell and Burns (2007), any acute illness or injury can predispose a
patient to several complex conditions including sepsis and Multiple Organ
Dysfunction Syndrome (MODS). Systemic Inflammatory Response Syndrome (SIRS) is
a systemic response to a clinical trigger, such as an infection. The clinical
symptoms associated with SIRS are as follows: temperature of >38.0?C or <36.0?C, heart rate >90 (unless
taking a beta-blocker, calcium-channel blocker or the heart is paced), a
respiratory rate of >20 or PaCO2 <4.3kPa, white blood cell count >12
or <4 (Peel, 2008).
The term SIRS was coined by Roger
Bone in 1991. He defined it as having the clinical presentations of at least
two of the afore mentioned criteria. He further elaborated that sepsis can be
defined as SIRS with the identification of a confirmed bacterial infection
(Pugin, 2008).
Taking a closer look at how the
body attempts to mount a response to the presence of a triggering event. This
is known as the inflammatory process. The initial response begins at the
cellular level, white blood cells (WBC); specifically macrophages and monocytes
are released into the bloodstream. Cytokines are generated and released by
these WBC’s. Cytokines are proteins that act as mediators during the
inflammatory response. They include tumor necrosis factor, interleukins and
platelet activating factor. This release of cytokines attracts neutrophils to
aide in the fight. The continued release of the cytokines is directly
associated with the clinical manifestations of SIRS (Kleinpell, 2003).
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