Page 1911 - Cote clinical veterinary advisor dogs and cats 4th

955.e6 Systemic Inflammatory Response Syndrome

• Avoid medications known to cause specific PROGNOSIS & OUTCOME hospitalized in a veterinary teaching hospital. J
Am Vet Med Assoc 249(1):65-71, 2016.
organ toxicity, especially certain antibiotics The prognosis/outcome for SIRS depends on Conti-Patara A, et al: Changes in tissue perfusion
VetBooks.ir present (e.g., amikacin should be avoided the underlying cause and disease severity. parameters in dogs with severe sepsis/septic shock
if single or multiple organ dysfunction is
in response to goal-directed hemodynamic opti-
in patients with acute kidney injury or
mization at admission to ICU and the relation to
PEARLS & CONSIDERATIONS
dehydration).
outcome. J Vet Emerg Crit Care 22(4):409-418,
2012.
Possible Complications Comments DeClue AE, et al: Plasma inflammatory mediator
• SIRS is associated with critical illness and can • Some patients may meet criteria for SIRS concentration at ICU admission in dogs with
result in high mortality rates if the underlying but not be systemically ill. It is important to naturally developing sepsis. J Vet Intern Med
disease is untreated or if single or multiple note that patients with SIRS have underly- 26:624-630, 2012.
organ failure develops. ing illness and usually feel sick on hospital DeClue AE, et al: Clinical and immunologic assess-
• Animals with SIRS from a noninfectious presentation. ment of sepsis and the systemic inflammatory
response syndrome in cats. J Am Vet Med Assoc
cause can develop infections or sepsis second- • Sepsis is the most important rule-out for 238(7):890-897, 2011.
ary to aspiration pneumonia, GI bacterial patients with SIRS. Early collection of Fransson BA, et al: C-reactive protein, tumor
translocation, or hospital-acquired infection. samples for cultures (e.g., blood, urine, necrosis factor alpha, and interleukin-6 in dogs
airway fluid) is recommended. Nosocomial with pyometra and SIRS. J Vet Emerg Crit Care
Recommended Monitoring infection can lead to sepsis in patients 17(4):373-381, 2007.
• Serial assessment of vital parameters (tem- presenting initially with noninfectious SIRS. Gebhardt C, et al: Use of C-reactive protein to predict
perature, heart rate, respiratory rate and • SIRS can exist without sepsis, although it outcome in dogs with systemic inflammatory
effort, mentation, blood pressure, urine may lead to septic sequela. response syndrome or sepsis. J Vet Emerg Crit
Care 19(5):450-458, 2009.
output) is indicated for all patients with Hardie EM: Life-threatening bacterial infection.
SIRS. SUGGESTED READING Compend Contin Educ Pract Vet 17(6):763-778,
• Trends in white blood cell counts and de Laforcade AM: Systemic inflammatory response. 1995.
biochemical markers of organ function must In Silverstein D, et al, editors: Small animal critical
be monitored closely. care medicine, St. Louis, 2009, Saunders, pp 46-48. AUTHORS: Melissa Bucknoff, DVM, DACVECC; Danna
• Oxygenation status should be monitored M. Torre, DVM, DACVECC
with pulse oximetry and/or arterial blood ADDITIONAL SUGGESTED EDITOR: Benjamin M. Brainard, VMD, DACVAA,
DACVECC
gas analysis. READINGS
• Therapeutic endpoint monitoring is impor- Babyak JM, et al: Epidemiology of systemic inflam-
tant to help guide ongoing treatment plan. matory response syndrome and sepsis in cats

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