系统性炎症反应综合征 (SIRS) 的自然史. 一个前性研究研究
M S Rangel-Frausto1, D Pittet, M Costigan
1Department of Internal Medicine, University of Iowa College of Medicine, Iowa City.
JAMA
|January 11, 1995
概括
系统性炎症反应综合征 (SIRS) 通常会发展为败血症,严重败血症和败血症休克,在每个阶段死亡率都会增加. 这种进展凸显了早期识别和干预感染应答综合征的关键需求.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 系统性炎症反应综合征 (SIRS) 是一种复杂的生物对感染的反应.
- 败血症,严重败血症和败血症休克代表了这种反应的升级阶段.
- 了解这些综合征的流行病学和临床进展对于患者的治疗结果至关重要.
研究的目的:
- 定义SIRS,败血症,严重败血症和败血症休克的流行病学.
- 调查与这些感染相关综合征相关的临床进展和结果.
主要方法:
- 在第三级医疗机构进行的前性队列研究.
- 包括符合SIRS标准的患者 (发烧/低温,心动减速,心动暂停,白血球数异常).
- 随访28天或直到出院,监测败血症,严重败血症,败血症休克,器官功能障碍和死亡.
主要成果:
- 68%的入院患者符合SIRS标准,在ICU和病房之间发生率不同.
- 在SIRS患者中,26%患有败血症,18%患有严重败血症,4%患有败血症.
- 死亡率从SIRS (7%) 逐步增加到败血症 (16%),严重败血症 (20%) 和败血症休克 (46%).
结论:
- 这项研究提供了从SIRS到败血症,严重败血症和败血症休克的临床进展的证据.
- 这些发现强调了承认SIRS是更严重疾病的先驱的重要性.
- 需要进一步的研究来了解具有类似临床轨迹的培养负病例.
相关概念视频
Inflammatory Response I: Vascular and Cellular
The inflammatory response is the body's defense against infection, injury, or irritation from bacteria, trauma, toxins, or heat. Inflammation helps locate and destroy pathogens and remove damaged tissue elements to heal the body. During this initial phase, fluid, blood products, and nutrients migrate to the injured area, resulting in redness, heat, swelling, ache, and loss of function. Moreover, signs of systemic inflammation include fever, increased WBC count, malaise, anorexia, nausea,...
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
Stress Response System
The stress response system, also known as the fight-or-flight response, is the body's automatic physiological reaction to perceived threats. Hans Selye introduced the concept of General Adaptation Syndrome (GAS) to describe the predictable pattern of changes that occur in response to stress. GAS consists of three sequential stages: alarm, resistance, and exhaustion. This model helps explain how chronic stress can contribute to health problems.
Alarm stage
In the alarm stage, the body's initial...
Alarm stage
In the alarm stage, the body's initial...
Acute Inflammation III: Local and Systemic Effects
Acute inflammation produces a coordinated set of local and systemic changes that limit injury, eliminate pathogens, and initiate repair. These responses arise within minutes of infection, trauma, or chemical insult and are driven by vascular alterations and leukocyte-derived mediators. When the stimulus resolves, the reaction typically abates within days.Local EffectsAt the site of injury, arteriolar vasodilation increases blood flow, resulting in redness and warmth. Simultaneously, increased...


