Review Article
Volume 7 Issue 2 - 2020
Management of Systemic Inflammatory Response Syndrome (SIRS) and Sepsis in Children. A Systematic Literature Review
Yaser Reda Mandorah1*, May Mohammed Alkhezzi2, Mazi Mohammed Alanazi3, Maali Omar Alrashed4, Noura Mohssen Alassaf5, Mohammad Hassan Haroobi6, Ayman Ali Albarrak7, Abdullah Salah Alahmadi8, Hasnaa Ahmad Alhussan9 and Bader Abdulwahab Alamer9
1King Abdulaziz University, Jeddah, Saudi Arabia
2Qassim University, Qassim, Saudi Arabia
3King Saud Medical City, Riyadh, Saudi Arabia
4King Saud Bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
5Qassim University, Qassim, Saudi Arabia
6Jazan University, Jazan, Saudi Arabia
7King Faisal University, Alahsa, Saudi Arabia
8Imam Mohammed Bin Saud Islamic University, Riyadh, Saudi Arabia
9King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
*Corresponding Author: Yaser Reda Mandorah, King Abdulaziz University, Jeddah, Saudi Arabia.
Received: January 13, 2020; Published: January 22, 2020


This review is aiming to discuss the management of systemic of inflammatory response syndrome (SIRS) and sepsis in children, the presented review was conducted between November 2018 to September 2019 by searching in Medline, Embase, Web of Science, Science Direct, BMJ journal and Google Scholar for, researches, review articles and reports, published over the past years. Were searched up to September 2019 for published and unpublished studies and without language restrictions, if several studies had similar findings, we randomly selected one or two to avoid repetitive results. On the basis of findings and results this review found the main goal of the management after the stabilizations of the patient hemodynamic; is to eliminate of the treat the triggering cause, then the use of pro-inflammatory and anti-inflammatory cytokine, interferon gamma-1b, and Insulin, are show evidences to be effective in the management of inflammatory response syndrome (SIRS) and sepsis in children.

Keywords: Management; Systemic of Inflammatory Response Syndrome (SIRS); Sepsis; Children


  1. Watson RS., et al. “The epidemiology of severe sepsis in children in the United States”. American Journal of Respiratory and Critical Care Medicine 167 (2003): 695-701.
  2. Sepsis Alliance. “Frequently asked questions about sepsis and Sepsis Alliance”.
  3. Zimmer S., et al. “Effects of endotoxin on the Th1/Th2 response in humans”. Journal of Burns Care Rehabilitation 17 (1996): 491-496.
  4. Taniguchi T., et al. “Change in the ratio of interleukin-6 to interleukin-10 predicts a poor outcome in patients with systemic inflammatory response syndrome”. Critical Care Medicine 27 (1999): 1262-1264.
  5. Pinsky MR., et al. “Serum cytokine levels in human septic shock: relation to multiple-system organ failure and mortality”. Chest 103 (1993): 565-575.
  6. Marty C., et al. “Circulating interleukin-8 concentrations in patients with multiple organ failure of septic and nonseptic origin”. Critical Care Medicine 22 (1994): 673-679.
  7. Gerard C., et al. “Interleukin 10 reduces the release of tumor necrosis factor and prevents lethality in experimental endotoxemia”. Journal of Experimental Medicine 177 (1993): 547-550. 
  8. Howard M., et al. “Interleukin 10 protects mice from lethal endotoxemia”. Journal of Experimental Medicine 177 (1993): 1205-1208.
  9. Bone RC. “Immunologic dissonance: a continuing evolution in our understanding of the systemic inflammatory response syndrome and the multiple organ dysfunction syndrome”. Annals of Internal Medicine 125 (1996): 690-691. 
  10. Fisher CJ., et al. “Treatment of septic shock with the tumour necrosis factor: Fc fusion protein”. The New England Journal of Medicine 334 (1996): 1697-1702.
  11. Bone RC. “Sir Isaac Newton, sepsis, SIRS, and CARS”. Critical Care Medicine 24 (1996): 1125-1128. 
  12. Doherty GM., et al. “Evidence for IFN-gamma as a mediator of lethality of endotoxin and tumor necrosis factor-alpha”. Journal of Immunology 149 (1992): 1666-1670.
  13. Redmond HP., et al. “Inhibition of macrophage-activating cytokines is beneficial in the acute septic response”. Annuals of Surgery 214 (1991): 502-508.
  14. Ziegler EJ., et al. “Treatment of gram-negative bacteremia and septic shock with HA-1A human monoclonal antibody against endotoxin”. The New England Journal of Medicine 324 (1991): 429-436. 
  15. Fisher CJ., et al. “Influence of an anti-tumor necrosis factor monoclonal antibody on cytokine levels in patients with sepsis”. Critical Care Medicine 21 (1993): 318-327.
  16. Fisher CJ., et al. “Recombinant human interleukin 1 receptor antagonist in the treatment of patients with sepsis syndrome: results from a randomized, double blind, placebo-controlled trial”. JAMA 271 (1994): 1836-1843.
  17. Dhainaut JF., et al. “Platelet activating factor receptor antagonist BN 52021 in the treatment of severe sepsis: a randomized, double-blind, placebo-controlled, multi-center clinical trial”. Critical Care Medicine 22 (1994): 1720-1728.
  18. Bone RC. “Why sepsis trials fail”. JAMA 276 (1996): 565-566. 
  19. Luce JM. “Introduction of new technology into critical care practice: a history of HA-1A human monoclonal antibody against endotoxin”. Critical Care Medicine 21 (1993): 1233-1241.
  20. Platzer C., et al. “Up-regulation of monocytic IL-10 by tumor necrosis factor-an and cAMP elevating drugs”. International Immunology 7 (1995): 517-523.
  21. Volk H-D., et al. “Alterations in function and phenotype of monocytes from patients with septic disease: predictive value and new therapeutic strategies”. Behring-Institute-Mitteilungen 88 (1991): 209-215.
  22. Dcke WD., et al. “Improvement of monocyte function: a new therapeutic approach?” In: Reinhart K, Eyrich K, eds. Sepsis: Current Perspectives in Pathophysiology and Therapy. New York: Springer-Verlag NY Inc (1994): 473-500.
  23. van den Berghe G., et al. “Intensive insulin therapy in critically ill patients”. The New England Journal of Medicine 345 (2001): 1359-1367.
  24. Jeschke MG., et al. “Insulin attenuates the systemic inflammatory response to thermal trauma”. Molecular Medicine 8 (2002): 443-450.
  25. PC Ng., et al. “Pro-inflammatory and anti-inflammatory cytokine responses in preterm infants with systemic infections”. Archives of Disease in Childhood. Fetal and Neonatal Edition 88 (2003): F209-F213.
  26. Wolfgang J., et al. “Interferon Gamma-1b in the Treatment of Compensatory Anti-inflammatory Response Syndrome”. JAMA 157 (1997): 389-393.
  27. Marc G., et al. “Insulin Treatment Improves the Systemic Inflammatory Reaction to Severe Trauma”. Annuals of Surgery 239.4 (2004): 553-560.
  28. Chakraborty RK and Burns B. “Systemic Inflammatory Response Syndrome” (2019). 
Citation: Yaser Reda Mandorah., et al. “Management of Systemic Inflammatory Response Syndrome (SIRS) and Sepsis in Children. A Systematic Literature Review”. EC Gastroenterology and Digestive System 7.2 (2020): 01-06.

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