The systemic inflammatory response syndrome

Tracy Toliver-Kinsky, Makiko Kobayashi, Fujio Suzuki, Edward R. Sherwood

Research output: Chapter in Book/Report/Conference proceedingChapter

20 Scopus citations


Severe burn injuries induce a systemic response that is characterized by cardiopulmonary, immunological, and metabolic perturbations and is described as the systemic inflammatory response syndrome (SIRS). The initial inflammatory response to burn injury results from activation of signaling pathways in predominantly immune cells by intracellular molecules that are released from damaged cells. These molecules, known as damage-associated molecular patterns (DAMPs), cause the release of cytokine and noncytokine mediators of inflammation. A compensatory response, known as the counter anti-inflammatory response syndrome (CARS), is mounted and, if persistent, can lead to immunosuppression and susceptibility to infections. A prolonged existence of SIRS and CARS can lead to severe muscle protein catabolism, described as persistent inflammation, immunosuppression, and catabolism syndrome (PICS), and is associated with an increased risk of multiorgan failure and death. This chapter reviews our knowledge of this systemic response and the associated perturbations in immunological, cardiovascular, and pulmonary function.

Original languageEnglish (US)
Title of host publicationTotal Burn Care
Subtitle of host publicationFifth Edition
PublisherElsevier Inc.
ISBN (Electronic)9780323497428
ISBN (Print)9780323476614
StatePublished - 2018


  • Damage-associated molecular patterns
  • Immunosuppression
  • Inflammation
  • Multiorgan failure
  • Multiple organ dysfunction syndrome
  • Shock
  • Toll-like receptors

ASJC Scopus subject areas

  • General Medicine


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