Systemic inflammatory response syndrome and sepsis in major vascular surgery

Abstract

This study aimed to identify relationships between post-operative systemic inflammatory response syndrome (SIRS) and sepsis, and markers of immunological, neuroendocrine, nutritional and psychological status ; to examine relationships between psychological variables and neuroendocrine responses to surgery; and to identify differences in immunological and neuroendocrine responses to open abdominal aortic aneurysm (AAA) repair compared with endovascular aneurysm repair (EVAR). It was concluded that higher pre-operative CD11b may be associated with more severe SIRS following major vascular surgery. Lower fat free mass and skeletal muscle mass are associated with more severe SIRS after AAA repair. Neuroendocrine responses reflect rather than predict post-operative SIRS and sepsis. No relationships between psychological parameters and neuroendocrine reponses to surgery were identified. Robust evidence of a greater inflammatory response to open AAA repair than EVAR has clarified contradictory reports in existing literature.