Effects of SIRS
TN’s persistent fevers most likely were due to a severe
form of SIRS (due to trypsin release with subsequent
cytokine production). Inflammatory states are associated
with temperature dysregulation,24 and a wide variety of
nursing and medical interventions may be used to bring
a patient’s temperatures to equilibrium. Another effect
of SIRS is pulmonary edema, which TN experienced.
The mixed respiratory-metabolic acidosis most likely was due to this combination of SIRS, dehydration,
atelectasis, and pulmonary edema.