Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2008 Dec;29(4):617-25, viii.
doi: 10.1016/j.ccm.2008.06.010.

The compensatory anti-inflammatory response syndrome (CARS) in critically ill patients

Nicholas S Ward  1 , Brian Casserly, Alfred Ayala
Affiliations
Review

The compensatory anti-inflammatory response syndrome (CARS) in critically ill patients

Nicholas S Ward et al. Clin Chest Med. 2008 Dec.

Abstract

Like the systemic inflammatory response syndrome (SIRS), the compensatory anti-inflammatory response syndrome (CARS) is a complex pattern of immunologic responses to severe infection or injury. The difference is that while SIRS is a proinflammatory response tasked with killing infectious organisms through activation of the immune system, CARS is a global deactivation of the immune system tasked with restoring homeostasis. Much research now suggests that the timing and relative magnitude of this response have a profound impact on patient outcomes.

PubMed Disclaimer

Figures

Fig.1
Fig.1
Three different immunologic responses to sepsis in three hypothetical patients of varying pre-existing health status. The relative magnitude of the anti-inflammatory (CARS) response in relation to the proinflammatory (SIRS) response is what is important in determining death in many sepsis patients. (From Hotchkiss RS, Karl IE. Medical progress: the patho-physiology and treatment of sepsis. N Engl J Med 2003;348(2):47; with permission.)
See this image and copyright information in PMC

References

    1. Bone RC. Sir Isaac Newton, sepsis, SIRS, and CARS. Crit Care Med. 1996;24(7):1125–8. - PubMed
    1. Freeman BD, Natanson C. Anti-inflammatory therapies in sepsis and septic shock. Expert Opin Investig Drugs. 2000;9(7):1651–63. - PubMed
    1. MacLean LD, Meakins JL, Taguchi K, et al. Host resistance in sepsis and trauma. Ann Surg. 1975;182(3):207–17. - PMC - PubMed
    1. Munster AM. Post-traumatic immunosuppression is due to activation of suppressor T cells. Lancet. 1976;1(7973):1329–30. - PubMed
    1. Meakins JL, Pietsch JB, Bubenick O, et al. Delayed hypersensitivity: indicator of acquired failure of host defenses in sepsis and trauma. Ann Surg. 1977;186(3):241–50. - PMC - PubMed

MeSH terms

Substances