Systemic Inflammatory Response Syndrome following Gastrointestinal Surgery
Introduction: Systemic inflammatory response syndrome symptoms immediately after surgery have lately been regarded as potential warnings of impending post-operative complications and multiple organ failure. This study was conducted to find out the clinical significance of systemic inflammatory response syndrome in postoperative patients and to investigate the relationship between the duration of post-operative systemic inflammatory response syndrome and the post-operative morbidity and mortality.
Methods: Total 30 patients who received different gastrointestinal surgery and fulfilled the diagnostic criteria for systemic inflammatory response syndrome between 2006 and 2008 at Kathmandu Medical College Teaching Hospital were included. Patients were analyzed for preoperative physiologic status, surgical stress parameters, and postoperative status of systemic inflammatory response syndrome, complications, and end-organ dysfunction.
Results: Duration of systemic inflammatory response syndrome or positive criteria's number of systemic inflammatory response syndrome after surgery significantly correlated with surgical stress parameters (blood loss/body weight and operation time). Septic complications and prolongation of systemic inflammatory response syndrome were associated with multiple organ dysfunction syndrome and increased mortality.
Conclusions: Systemic inflammatory response syndrome is a useful criterion for the recognition of postoperative complications and end-organ dysfunctions. Early recovery from systemic inflammatory response syndrome may arrest the progression of organ dysfunction, thus reducing the mortality.
Keywords: gastrointestinal surgery; multiple organ dysfunction syndrome; systemic inflammatory response syndrome. [PubMed]
2. Ragel-Frausto MS, Pittet D, Costigan M et al. The natural history of the systemic inflammatory response syndrome. JAMA. 1995;273:117-123. [PubMed | FullText]
3. Knaus WA, Harrell FE, Fisher CJ et al. The clinical evaluation of new drugs for sepsis: a prospective study design based on survival analysis. JAMA. 1993;270:1233-41. [PubMed]
4. Pittet D, Rangel-Frausto S, Li N et al. Systemic inflammatory response syndrome, sepsis, severe sepsis, and septic shock: incidence, morbidities and outcomes in surgical ICU patients. Intensive Care Med. 1995;21:302-9. [PubMed]
5. Baue AE, Durham R, Faist E. Systemic inflammatory response syndrome (SIRS), multiple organ dysfunction syndrome (MODS), multiple organ failure (MOF): are we winning the battle? Shock. 1998 ;10:79-89. [PubMed]
6. Velasco E, Thuler LC, Martins CA, Dias LM, Conalves VM. Risk factors for infectious complications after abdominal surgery for malignant disease. Am J Infect Control. 1996;24:1-6. [PubMed]
7. Faist E, Wichmann M, Kim C. Immunosuppression and immunomodulation in surgical patients. Curr Opin Crit Care. 1997;3: 293-8. [WebLink]
8. Sibbald WJ, Doig G, Inman KJ. Sepsis, SIRS and infection. Intensive Cre Med. 1995;21:299-301. [PubMed]
9. Harvey G. Klein M D. Immunomodulatory aspects of transfusion: a once and future risk? Anesthesiology.1999;91:861-5. [FullText]
10. Haga Y, Beppu T, Doi K et al. Systemic inflammatory response syndrome and organ dysfunction following gastrointestinal surgery. Crit Care Med. 1997;25:1994-2000. [PubMed]
11. Menger MD, Vollmar B. Systemic inflammatory response syndrome (SIRS) and sepsis in surgical patients. Intensive Care Med. 1996;22:616-7. [PubMed]
12. Mia Talmor, Lynn Hydo, Philip S. Relationship of Systemic Inflammatory Response syndrome to Organ dysfunction, Length of stay and Mortality in Critical surgical illness. Arch Surg.1999;134:81-7. [Full Text]
13. Namekata K, Takamori S, Kojima K et al. Significant changes in the serum levels of IL-6, h- HGF, and Type IV collagen 7S during the perioperative period of a Hepatectomy: Relevance to SIRS. Surg Today.2000;30:403-9. [DOI]
14. Bone RC. Toward a theory regarding the pathogenesis of the systemic inflammatory response syndrome: what we do and do not know about cytokine regulation. Crit Care Med.1996;24:163-72. [PubMed]
15. Bone RC, Sir Isaac Newton. Sepsis SIRS and CARS. Crit Care Med. 1996;24:1125-8. [PubMed]
16. Barie PS, Hydo LJ. Influence of multiple organ dysfunction syndrome on duration of critical illness and hospitalization. Arch Surg. 1996; 131:1318-25. [PubMed]
17. Godin PJ, Buchman TG. Uncoupling biological oscillators: a complementary hypothesis concerning the pathogenesis of multiple organ dysfunction syndrome. Crit Care Med. 1996;24:1107-16. [PubMed]
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