Name: Michaella L.

Maranan Yr/Sec: BSN 4B

POST TEST FOR SYSTEMIC INFLAMMATORY RESPONSE SYNDROME

1. FOR 20 POINTS. DISCUSS BRIEFLY THE RELATIONSHIP OF SHOCK, SIRS AND MODS.
(YOU MAY EXPLAIN YOUR ANSWER IN A WORD, DIAGRAM OR TABLE FORMAT).

SHOCK

LOW BLOOD FLOW MALDISTRIBUTION OF BLOOD FLOW

Cardiogenic Neurogenic
- Myocardial infarction - Spinal cord injury
- Dysrhythmias - Opioid overdose
- Cardiomyopathy
- Structural problems Anaphylactic
- Multiple transfusion
Hypovolemic - Severe allergic reaction
- Severe trauma with massive tissue Septic
injury - Pancreatitis
- Hemorrhage - Infection- sepsis

SYSTEMIC INFLAMMATORY RESPONSE SYNDROME

- Mediator excess: cytokines (e.g tumor necrosis factor, interleukins) oxygen free
radicals, etc.
- Widespread endothelial injury and dysfunction
- Vasodilation and increased capillary permeability
- Tissue edema
- Neutrophil entrapment in microcirculation

MULTIPLE ORGAN DYSFUNCTION SYNDROME

TARGET ORGANS
- Cardiovascular dysfunction
- Lung dysfunction
- Gastrointestinal dysfunction
- Liver dysfunction
- CNS dysfunction
- Renal dysfunction
- Skin dysfunction
When SIRS is the result of confirmed infectious process, it is termed 'SEPSIS', and is frequently
associated with the development of multiple organ dysfunction and failure. This is the most
common cause of death in patients who have severe sepsis. Sepsis is a clinical syndrome that
complicates severe infection and is characterized by the systemic inflammatory response
syndrome (SIRS), immune dysregulation, microcirculatory derangements, and end-organ
dysfunction. Septic shock was defined as sepsis plus a systolic blood pressure of ≤ 90 mmHg or
systolic blood pressure fall ≥ 40 mmHg from the baseline despite adequate fluid resuscitation or
the use of vasopressor agents. Human sepsis is thought to be systemic inflammatory response
syndrome (SIRS) that is activated by invasive infection. The multiple organ dysfunction
syndrome (MODS) is the identified failure of critical organ function in patients that have
sustained SIRS. Because SIRS and MODS are consequences of the excessive activation of
inflammation, extensive research and numerous clinical trials have pursued treatments that
would modify the inflammatory response.