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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.

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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.)
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