Advertisement

Definitions: Sepsis Versus SIRS

  • Jean-Louis Vincent
Part of the Perspectives on Critical Care Infectious Diseases book series (CCID, volume 2)

Abstract

Definitions are an essential and necessary aspect of understanding in all walks of life, from basic language skills to complex scientific reasoning. Definitions serve to provide us with a precise statement of the nature, properties, scope, or essential qualities of a word, or more abstractly, of an event, concept or process. Definitions can be simple or detailed and the degree of definition will depend on its purpose. Importantly, definitions must not be viewed as inflexible, but, rather, must be able to be adapted and adjusted as new information and knowledge becomes available regarding the item in question.

Keywords

Septic Shock Acute Pancreatitis Severe Sepsis Systemic Inflammatory Response Syndrome White Cell Count 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Vincent JL (1994) Sepsis and septic shock: Update on definitions. In: Eyrich K, Sprung C, Reinhart K (eds) Update in Intensive Care and Emergency Medicine. Springer Verlag, Berlin, pp 3–15.Google Scholar
  2. 2.
    Meakins JL, Marshall JC (1989) The gut as the motor of multiple system organ failure. In: Marston A, Buckley GB, Fiddian-Green R (eds) Splanchnic ischemia and multiple organ failure. Edward Arnold Ltd, London, pp 339–348.Google Scholar
  3. 3.
    Niebauer J, Volk HD, Kemp M, et al (1999) Endotoxin and immune activation in chronic heart failure: a prospective cohort study. Lancet 353: 1838–1842.PubMedCrossRefGoogle Scholar
  4. 4.
    Bone RC, Fisher CJ, Clemmer TP, Slotman GJ, Metz CA, Balk RA (1989) Sepsis syndrome: A valid clinical entity. Crit Care Med 17: 389–393.PubMedCrossRefGoogle Scholar
  5. 5.
    Circiumaru B, Baldock G, Cohen J (1999) A prospective study of fever in the intensive care unit. Intensive Care Med 25: 668–673.PubMedCrossRefGoogle Scholar
  6. 6.
    Clarke DE, Kimelman J, Raffin TA (1991) The evaluation of fever in the intensive care unit. Chest 100: 213–220.PubMedCrossRefGoogle Scholar
  7. 7.
    Clemmer TP, Fisher CJ, Bone RC, Slotman GJ, Metz GA, Thomas FO (1992) Hypothermia in the sepsis syndrome and clinical outcome. Crit Care Med 20: 1395–1401.PubMedCrossRefGoogle Scholar
  8. 8.
    Brun-Buisson C, Doyon F, Carlet J, et al (1995) Incidence, risk factors, and outcome of severe sepsis and septic shock in adults. A multicenter prospective study in intensive care units. J A M A 274: 968–974.PubMedCrossRefGoogle Scholar
  9. 9.
    Pittet D, Thievent B, Wenzel RP, Li N, Auckenthaler R, Suter PM (1996) Bedside prediction of mortality from bacteremic sepsis. A dynamic analysis of ICU patients. Am J Respir Crit Care Med 153: 684–693.PubMedGoogle Scholar
  10. 10.
    Calandra T, Baumgartner JD, Grau DG, et al (1990) Prognostic values of tumor necrosis factor/cachectin, interleukin-1, interferon-alpha, and interferon-gamma in the serum of patients with septic shock. J Infect Dis 161: 982–987.PubMedCrossRefGoogle Scholar
  11. 11.
    Pinsky MR, Vincent JL, Deviere J (1993) Serum cytokine levels in human septic shock: Relation to multiple-systems organ failure and mortality. Chest 103: 565–575.PubMedCrossRefGoogle Scholar
  12. 12.
    Terregino CA, Lopez BL, Karras DJ, Killian AJ, Arnold GK (2000) Endogenous mediators in emergency department patients with presumed sepsis: are levels associated with progression to severe sepsis and death? Ann Emerg Med 35: 26–34.PubMedCrossRefGoogle Scholar
  13. 13.
    Gogos CA, Drosou E, Bassaris HP, Skoutelis A (2000) Pro-versus anti-inflammatory cytokine profile in patients with severe sepsis: A marker for prognosis and future therapeutic options. J Infect Dis 181: 176–180.PubMedCrossRefGoogle Scholar
  14. 14.
    Brivet FG, Emilie D, Galanaud P (1999) Pro-and anti-inflammatory cytokines during acute severe pancreatitis: an early and sustained response, although unpredictable of death. Parisian Study Group on Acute Pancreatitis. Crit Care Med 27: 749–755.PubMedCrossRefGoogle Scholar
  15. 15.
    Ferguson KL, Taheri P, Rodriguez J, Tonapi V, Cardellio A, Dechert R (1997) Tumor necrosis factor activity increases in the early response to trauma. Acad Emerg Med 4: 1035–1040.PubMedCrossRefGoogle Scholar
  16. 16.
    Neumann FJ, Ott I, Gawaz M, et al (1995) Cardiac release of cytokines and inflammatory responses in acute myocardial infarction. Circulation 92: 748–755.PubMedCrossRefGoogle Scholar
  17. 17.
    Vonhof S, Brost B, Stille-Siegener M, Grumbach IM, Kreuzer H, Figulla HR (1998) Monocyte activation in congestive heart failure due to coronary artery disease and idiopathic dilated cardiomyopathy. Int J Cardiol 63: 237–244.PubMedCrossRefGoogle Scholar
  18. 18.
    Reinhart K, Wiegand-Löhnert C, Grimminger F, et al (1996) Assessment of the safety and efficacy of the monoclonal anti-tumor necrosis factor antibody fragment, MAK195F, in patients with sepsis and septic shock: A multicenter, randomized, placebo-controlled, dose ranging study. Crit Care Med 24: 733–742.PubMedCrossRefGoogle Scholar
  19. 19.
    Reinhart K, RAMSES Study Group (1998) Treatment of severe sepsis in patients with highly elevated IL-6 levels with anti-TNF monoclonal antibody MAK 195F: The RAMSES study. Crit Care 2: P18 (Abst).CrossRefGoogle Scholar
  20. 20.
    Matson A, Soni N, Sheldon J (1991) C-reactive protein as a diagnostic test of sepsis in the critically ill. Anaesth Intensive Care 19: 182–186.PubMedGoogle Scholar
  21. 21.
    Póvoa P, Almeida E, Moreira P, et al (1998) C-reactive protein as an indicator of sepsis. Intensive Care Med 24: 1052–1056.PubMedCrossRefGoogle Scholar
  22. 22.
    Miller PR, Munn DD, Meredith JW, Chang MC (1999) Systemic inflammatory response syndrome in the trauma intensive care unit: who is infected? J Trauma 47: 1004–1008.PubMedCrossRefGoogle Scholar
  23. 23.
    Assicot M, Gendrel D, Carsin H, Raymond J, Guilbaud J, Bohoun C (1993) High serum procalcitonin concentration in patients with sepsis and infection. Lancet 341: 515–518.PubMedCrossRefGoogle Scholar
  24. 24.
    Al-Nawas B, Krammer I, Shah PM (1996) Procalcitonin in diagnosis of severe infections. Eur J Med Res 1: 331–333.PubMedGoogle Scholar
  25. 25.
    Brunkhorst FM, Eberhard OK, Brunkhorst R (1999) Discrimination of infectious and noninfectious causes of early acute respiratory distress syndrome by procalcitonin. Crit Care Med 27: 2172–2176.PubMedCrossRefGoogle Scholar
  26. 26.
    Ugarte H, Silva E, Mercan D, de Mendonça A, Vincent JL (1999) Procalcitonin as a marker of infection in the intensive care unit. Crit Care Med 27: 498–504.PubMedCrossRefGoogle Scholar
  27. 27.
    Yao YM, Yu Y, Wang YP, Tian HM, Sheng ZY (1996) Elevated serum neopterin level: its relation to endotoxemia and sepsis in patients with major burns. Eur J Clin Invest 26: 224–230.PubMedCrossRefGoogle Scholar
  28. 28.
    Bossink AW, Groeneveld AB, Thijs LG (1999) Prediction of microbial infection and mortality in medical patients with fever: plasma procalcitonin, neutrophilic elastase-alphal-antitrypsin, and lactoferrin compared with clinical variables. Clin Infect Dis 29: 398–407.PubMedCrossRefGoogle Scholar
  29. 29.
    ACCP-SCCM Consensus Conference (1992) Definitions of sepsis and multiple organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20: 864–874.CrossRefGoogle Scholar
  30. 30.
    Vincent JL (1997) Dear Sirs, I’m sorry to say that I don’t like you.. Crit Care Med 25: 372–374.PubMedCrossRefGoogle Scholar
  31. 31.
    Pittet D, Rangel-Frausto S, Li N, et al (1995) Systemic inflammatory response syndrome, sepsis, severe sepsis and septic shock: incidence, morbidities and outcomes in surgical ICU patients. Intensive Care Med 21: 302–309.PubMedCrossRefGoogle Scholar
  32. 32.
    Rangel Frausto MS, Pittet D, Costigan M, Hwang T, Davis CS, Wenzel RP (1995) The natural history of the systemic inflammatory response syndrome (SIRS). A prospective study. J A M A 273: 117–123.Google Scholar
  33. 33.
    Salvo I, de Cian W, Musicco M, et al (1995) The Italian SEPSIS study: Preliminary results on the incidence and evolution of SIRS, sepsis, severe sepsis and septic shock. Intensive Care Med 21: S244–S249.PubMedCrossRefGoogle Scholar
  34. 34.
    Bossink AW, Groeneveld J, Hack CE, Thijs LG (1998) Prediction of mortality in febrile medical patients: How useful are systemic inflammatory response syndrome and sepsis criteria? Chest 113: 1533–1541.PubMedCrossRefGoogle Scholar
  35. 35.
    Opal SM (1998) The uncertain value of the definition for SIRS. Chest 113: 1442–1443.PubMedCrossRefGoogle Scholar
  36. 36.
    Marshall J (1997) Both the disposition and the means of cure: “Severe SIRS,” “sterile shock,” and the ongoing challenge of description. Crit Care Med 25: 1765–1766.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Jean-Louis Vincent
    • 1
  1. 1.Department of Intensive Care, Erasme HospitalFree University of BrusselsBrusselsBelgium

Personalised recommendations