Although alterations in these four parameters suffice
to define the clinical syndrome of SIRS, the systemic
response to infection involves changes in many more physiologic
parameters. In general, this systemic response includes
the development of a hyperdynamic cardiovascular state
characterized by increased cardiac output and decreased
systemic vascular resistance and a hypermetabolic state
characterized by increased oxygen consumption and carbon
dioxide production, production and utilization of glucose,
mobilization of free fatty acids, and breakdown of the body’s
muscle protein stores (4).