SIRS, Sepsis, MODS and DIC Flashcards
What is SIRS?
= systemic inflammatory response syndrome
- it is a self-amplifying dysregulated systemic inflammatory response
What is SIRS triggered by?
Bacterial toxins:
▪ Lipopolysaccharide derived from Gram-negative bacteria
▪ S aureus
▪ Burns, Neoplasia, Pancreatitis (non equine)
What can SIRS result in?
- coagulopathies
What was SIRS previously referred to as? What is this?
▪ Previously referred to as endotoxaemia
- Inflammation leading to cell death and apoptosis
– LPS has some direct roles
– Includes non-LPS bacteria
What is sepsis?
= SIRS + culture proven infection
What is severe sepsis?
- sepsis with organ hypo perfusion or dysfunction
What is septic shock?
= severe sepsis + systemic hypotension
Which animals is septic shock common in?
- common in foals
- rare in adult horses
- occurs in small animals also
What is multi-organ dysfunction syndrome?
▪Altered organ function in an acutely ill animal such that haemostasis cannot be maintained without intervention
▪Classified as either primary or secondary
Primary MODS
▪ Resulting from well-defined insult where organ dysfunction occurs early and is a direct consequence of the insult itself
– burns and neoplasia
Secondary MODS
▪ Organ failure not in direct response to the insult but as a
consequence of a host response (SIRS)
What is DIC?
= Disseminated Intravascular Coagulation ▪”Consumptive coagulopathy”
▪Pathological activation of coagulation
– Microvascular clotting
– Haemorrhagic diathesis
– Consumption of procoagulants
What is DIC associated with?
- SIRS, sepsis, septic shock
- MODS
– systemic neoplasia
– enteritis and colitis
DIC CS
▪In large animals, DIC is usually manifested by thrombosis rather than spontaneous haemorrhage
– Petechial haemorrhages
– Bleeding following trauma
-> Venupuncture
-> Surgical sites
-> Nasogastric intubation
This bleeding occurs as a result of using up pro-coagulatory agents and platelets
DIC diagnosis
3 out of 5 abnormalities of
▪ Thrombocytopoaenia (low platelet count
▪ Prolonged prothrombin time
▪ Prolonged activated partial thromboplastin time
▪ Increased fibrin degradation products
▪ Decreased antithrombin 3
▪ (low fibrinogen - not used very often as ref range <4g/l [i.e. hard to tel how low due to ref range])
Do horses seem to develop SIRS more or less readily than others species?
- much more readily
