Is BP is included in SIRS parameter?
BP is not included in the criteria for SIRS.
Systemic inflammatory response syndrome (SIRS) is an exaggerated defense response of the body to a noxious stressor (infection, trauma, surgery, acute inflammation, ischemia or reperfusion, or malignancy, to name a few) to localize and then eliminate the endogenous or exogenous source of the insult. It involves the release of acute-phase reactants, which are direct mediators of widespread autonomic, endocrine, hematological, and immunological alteration in the subject. Even though the purpose is defensive, the dysregulated cytokine storm can cause a massive inflammatory cascade leading to reversible or irreversible end-organ dysfunction and even death.
SIRS with a suspected source of infection is termed sepsis. Confirmation of infection with positive cultures is therefore not mandatory, at least in the early stages. Sepsis with one or more end-organ failures is called severe sepsis, and hemodynamic instability despite intravascular volume repletion is called septic shock. Together they represent a physiologic continuum with progressively worsening balance between pro and anti-inflammatory responses of the body.
The American College of Chest Physicians/Society of Critical Care Medicine-sponsored sepsis definitions consensus conference also identified the entity of multiple organ dysfunction syndrome (MODS) as the presence of altered organ function in acutely ill septic patients such that homeostasis is not maintainable without intervention.
Objectively, SIRS is defined by the satisfaction of any two of the criteria below:
-Body temperature over 38 or under 36 degrees Celsius.
-Heart rate greater than 90 beats/minute
-Respiratory rate greater than 20 breaths/minute or partial pressure of CO2 less than 32 mmHg
-Leukocyte count greater than 12000 or less than 4000 /microliters or over 10% immature forms or bands.
In the pediatric population, the definition is modified to a mandatory requirement of abnormal leukocyte count or temperature to establish the diagnosis, as abnormal heart rate and respiratory rates are more common in children.