How can systemic inflammatory reaction return a responsibility?

summary

Systemic inflammatory response syndrome (SIRS) is a kind of systemic nonspecific inflammatory response caused by severe injury of infectious or non infectious factors, such as infection, trauma, burn, operation and ischemia-reperfusion, which eventually leads to a group of clinical symptoms that the body loses control of inflammatory response. Systemic reactions caused by severe infection include changes in body temperature, respiration, heart rate and white blood cell count.

How can systemic inflammatory reaction return a responsibility?

The clinical causes of SIRS include the following two types. 1. Infection factors. Such as bacteria, viruses, fungi caused by systemic infection, clinical common in biliary tract infection, abdominal infection, trauma infection. 2. Non infectious factors. Such as hemorrhagic shock, ischemia, tissue injury, multiple trauma, acute pancreatitis, burns, poisoning, drug fever and so on.

Clinical manifestations 1. Respiratory rate and heart rate increased. 2. Abnormal temperature and peripheral white blood cell count or ratio. 3. Hypermetabolic state (high oxygen consumption, high gas flux, hyperglycemia, increased proteolysis and hyperlactemia) and hyperdynamic circulation state (high cardiac output and low peripheral resistance). 4. Organ hypoperfusion and excessive inflammation.

In the presence of corresponding damage factors, SIRS can be diagnosed if there are two or more of the following. 1. Body temperature > 38 ℃ or < 36 ℃. 2. Heart rate > 90 beats / min or hypotension (systolic blood pressure < 90 mmHg, or lower than baseline > 40 mmHg). 3. Shortness of breath (> 20 beats / min) or hyperventilation (PaCO2 < 32mmhg). 4. Peripheral blood leukocyte count > 12 x 109 / L, or neutrophil percentage > 10%, but other reasons that can cause the above acute abnormal changes should be excluded.

matters needing attention

Treatment 1. Anti infection. Antibiotics can be given intravenously or orally. 2. Immunoprotective therapy. Gamma globulin was given intravenously every day. 3. Inhibition and elimination of inflammatory mediators and cytokines 1) non steroidal anti-inflammatory drugs: ibuprofen suspension is commonly used（ 2) Monoclonal antibodies against inflammatory mediators（ 3) Free radical scavenger: a lot of vitamin C, vitamin E, etc. 4. Anti shock treatment. Fluid resuscitation and vasoactive drugs.