What is the focus of treatment for systemic inflammatory response syndrome (SIRS)?

Updated: May 07, 2018
  • Author: Lewis J Kaplan, MD, FACS, FCCM, FCCP; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

Treatment focuses on the underlying cause. Early care to treat for septic shock is critical in patients suspected of infection and hemodynamic instability.

Routine prophylaxis, including deep vein thrombosis (DVT) and stress ulcer prophylaxis, should be initiated when clinically indicated in severely ill bed-ridden patients, especially if they require mechanical ventilation. Long-term antibiotics, when clinically indicated, should be as narrow spectrum as possible to limit the potential for superinfection (suggested by a new fever, a change in the white blood cell [WBC] count, or clinical deterioration). Unnecessary vascular catheters and Foley catheters should be removed as soon as possible.

SIRS is a syndrome, not a disease. Treatment of SIRS should focus on possible inciting causes. As the causes of SIRS include a wide range of disorders (eg, acute myocardial infarction, community-acquired pneumonia, [5] pancreatitis), the appropriate interventions will likewise differ from patient to patient.

Studies of tumor necrosis factor–alpha (TNF-α) and interleukin 1 (IL-1) receptor antagonists, antibradykinin, platelet-activating factor receptor antagonists, and anticoagulants (antithrombin III) have not shown statistically significant benefits in SIRS. Variable results for sepsis and septic shock have been reported. These medications have no role in treating patients who meet criteria for SIRS only.


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