Toward an epidemiology and natural history of SIRS (systemic inflammatory response syndrome)

Article Abstract:

Systemic inflammatory response syndrome (SIRS) is the proposed name for any severe illness caused by widespread inflammation and endothelial damage whether or not a bacterial infection is present. It would include sepsis, which is characterized by widespread bacterial infection, but would also include conditions in which no organism can be detected. To determine the characteristics and prognosis of this new condition, data from four studies of patients with suspected sepsis were reviewed. Bacterial infection was never detected in 15% of the patients, and less than half of those with probable infection had evidence of bacteria in their blood. Only one-fourth to one-third had gram-negative bacterial infections. Some of the studies tested various drugs in the treatment of sepsis. Data from patients taking a placebo revealed that mortality from SIRS is 26% at 14 days and 42% at one month.

Prognosis, Bacterial infections

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Why sepsis trials fail

Article Abstract:

It is possible that the reason many drugs to treat sepsis have failed to improve survival rates is because the underlying hypothesis is incorrect. Sepsis occurs when a serious infection or injury triggers shock and organ failure. It was assumed to be caused by widespread inflammation and most of the drugs tested have been anti-inflammatory agents. An alternate hypothesis is that individual patients fluctuate between a pro-inflammatory state and an anti-inflammatory state as the body seeks to regain homeostasis. Blood tests to detect which state patients are in could lead to more effective treatments.

Physiological aspects

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