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>Journals >Medicina Crítica >Year 2009, Issue 4


Duarte MJ, Espinosa LRF, Sánchez RG, De Santiago LJ, Díaz MS, Lee Eng CVE
Inflammatory systemic response syndrome. Physiopathological aspects
Rev Asoc Mex Med Crit y Ter Int 2009; 23 (4)

Language: Español
References: 66
Page: 225-233
PDF: 93.57 Kb.


Full text




ABSTRACT

The systemic inflammatory response syndrome (SIRS) is very common in critically ill patients, being found in various conditions including trauma, surgery, and hypoxic injuries. Clinical and laboratory signs of systemic inflammation, including changes in body temperature, tachycardia, or leukocytosis, are neither sensitive nor specific enough for the diagnosis of sepsis. This issue is of paramount importance because therapy and outcomes differ greatly between patients with and those without sepsis. Microbiological culture can be used to distinguish sepsis from non-infectious conditions. However, this method lacks sensitivity and specificity, and there is often a substantial time delay. Indiscriminate use of broad-spectrum antibiotics for patients with SRIS but without sepsis has led to the development of resistant strains and increased toxicity and cost. Hyperglycemia is a major cause of the systemic inflammatory response. Angiopoietins are a novel class of angiogenic growth factors that act selectively on endothelial cells. Angiopoietin 2 (Ang-2) is up-regulated by diverse proinflammatory stimuli and promotes inflammation and vascular leakage, it might participate in the ongoing inflammatory process.


Key words: Systemic inflammatory response syndrome, sepsis, hyperglycemia, angiopoietin, vascular leakage.


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