[SIRS in surgical stress].
It has been suggested that SIRS are triggered by superfluous pro-inflammatory cytokine production, and that organ injury is caused by uncontrolled inflammatory responses. However, the results of clinical studies, on the usefulness of specific cytokine antagonists and anti-TNF antibodies for the treatment of septic shock, have been unsatisfactory. The reason for this might have been that when uncontrolled inflammatory reactions progressed locally, anti-inflammatory reactions were elevated in the circulated blood by way of CARS, thus the timing of administration and pharmacokinetics did not match clinical course. Recent research has shown that SIRS is always accompanied by CARS, and since it seems to do the amplitude of SIRS and CARS to each other so that there may be a deep valley, if there is a high mountain. We introduce the recent knowledge which indicates that SIRS is a preliminary alert for not only organ dysfunction but also immunosuppression after severe injury or major surgery.
Sato
N
N
Department of Surgery 1, Iwate Medical University, School of Medicine, Morioka.
Endo
S
S
Ikeda
K
K
Koeda
K
K
Kimura
Y
Y
Iwaya
T
T
Ishida
K
K
Maesawa
C
C
Iijima
S
S
Uesugi
N
N
Saito
K
K
D016207:Cytokines / Q000378:metabolism / Q000502:physiology; D006801:Humans; D018836:Inflammation Mediators; D013312:Stress, Physiological / Q000209:etiology* / Q000378:metabolism; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology*
D016207:Cytokines; D018836:Inflammation Mediators