Systemic Inflammatory Response Syndrome vs. Sepsis – 3 criteria
Posted in Lectures on 30 April 2019
General Surgery Resident
Systemic Inflammatory Response Syndrome (SIRS) requires more than one of the following findings: temperature >38°C or <35°C; heart rate >90 beats per minute; respiratory rate >20 breaths per minute or PaCO2 <32 mmHg; and white blood cell count >12,000/cu mm, <4,000/cu mm, or >10% immature (band) forms. When using the term “sepsis”, this means that the SIRS is due to an infectious origin. Sepsis, when not treated correctly, evolves producing multiorgan dysfunction. Its only management is based on source control, being the time the most crucial factor for survival. In this open classroom, we will revise the different definitions that sepsis has presented over the years and the screening scores that we use daily.
When analyzing the new Sepsis-3 scoring systems (SOFA and qSOFA), it was found that a lack of sensitivity was presented, so its implementation as a screening score is limited. As the primary use of these scores is reducing the time until intervention, high sensitivity is required. Until a new score presents high sensitivity and specificity, Sepsis-2 score should be used as a screening tool and Sepsis-3 as a stratification tool for identified patients.