title: Postoperative metabolic and circulatory responses in patients that express SIRS after major digestive surgery.
abstract: OBJECTIVE
  Systemic inflammatory response syndrome (SIRS) includes a number of pathologic states because of its loose definition. This study assessed differences in metabolic and circulatory host responses in various patients with SIRS perioperatively.
  
  
  METHODS
  Fifty-four patients who underwent abdominal surgeries [gastric resection (n=20), colorectal resection (n=24), hepatic resection (n=8)] were divided into two groups: Group A; SIRS (+) on 1 postoperative day (POD), (n=29), B; SIRS (-) on 1 POD, (n=25). The other eight non-operated patients with SIRS caused by infection were enrolled in Group C, as common SIRS. Indirect calorimetry, body impedance measurement to assess water compartments and pulse dye-densitometry for hemodynamic examination were performed in subjects until 14 POD.
  
  
  RESULTS
  The ratio of energy expenditure to basal energy expenditure (%REE) was significantly increased postoperatively, and there were significant differences on %REE from 3 POD to 14 POD between groups A and B. However, %REE in group C was 162+/-23%, which was significantly increased compared with that at 1 POD of groups A (130 +/- 17%) and B (125+/-18%). Cardiac output in group A showed a significant increase until 3 POD compared with that in group B but was significantly lower than that in group C.
  
  
  CONCLUSIONS
  Subjects with common SIRS caused by infection were significantly more hypermetabolic than subjects with postoperative SIRS. Adequate energy intake and circulatory management should be cautiously determined according to the severity of SIRS.
authors.affiliation: Department of Surgery, National Kochi Hospital, Kochi, Japan. masa1192@tokushima-med.jrc.or.jp
authors.forename: M
authors.initials: M
authors.lastname: Ishikawa
authors.forename: M
authors.initials: M
authors.lastname: Nishioka
authors.forename: N
authors.initials: N
authors.lastname: Hanaki
authors.forename: T
authors.initials: T
authors.lastname: Kikutsuji
authors.forename: T
authors.initials: T
authors.lastname: Miyauchi
authors.forename: Y
authors.initials: Y
authors.lastname: Kashiwagi
authors.forename: H
authors.initials: H
authors.lastname: Miki
mesh_terms: D000368:Aged; D001810:Blood Volume / Q000502:physiology*; D001823:Body Composition; D001834:Body Water; D002302:Cardiac Output / Q000502:physiology*; D016022:Case-Control Studies; D003720:Densitometry; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D017097:Electric Impedance; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006801:Humans; D007424:Intracellular Fluid; D008297:Male; D008875:Middle Aged; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology*