uti Urogenital Tract Infection Urogenit Tract Infect 2465-8243 2465-8510 Korean Association of Urogenital Tract Infection and Inflammation 10.14777/uti.2019.14.1.9 uti-14-9 Review Perioperative Risk Factors Related to Systemic Inflammatory Response Syndrome after Percutaneous Nephrolithotomy ChungHo Seok JungSeung Il Department of Urology, Chonnam National University Medical School, Gwangju, Korea Correspondence to: Seung Il Jung https://orcid.org/0000-0003-4864-8175 Department of Urology, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun 58128, Korea Tel: +82-61-379-7749, Fax: +82-61-379-7750 E-mail: drjsi@yahoo.co.kr 042019 20042019 141 913 01042019 23042019 23042019 Copyright © 2019 Korean Association of Urogenital Tract Infection and Inflammation 2019 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract

Percutaneous nephrolithotomy (PCNL) has become the standard treatment for large and complex kidney stones since its introduction in 1976. On the other hand, postoperative complications are not rare and can be quite significant. Of these complications, postoperative infectious complications, such as systemic inflammatory response syndrome (SIRS), remain a seminal event and a possible cause of perioperative mortality. Several recent studies have found a number of factors that increase the risk of SIRS after PCNL. These include preoperative factors (patient's characteristics) and factors associated with the intraoperative and postoperative findings. The present study describes the perioperative risk factors of SIRS after PCNL. These findings can help decrease the incidence of infectious complications, including SIRS, in patients undergoing PCNL.

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Definitions of SIRS, infection, and sepsis

SIRS Two or more of the following:
‐ Body temperature >38°C or <36°C
‐ Heart rate>90 bpm
‐ Respiratory rate>20 breaths/min or PaCO2<32 mmHg
‐ White blood cell count >12,000 cells/μl or <4,000 cells/μl
Infection Pathological process caused by the invasion of normally sterile tissue or fluid or the body cavity by pathogenic or potentially pathogenic micro-organisms
Sepsis Clinical syndrome defined by the presence of both SIRS and infection
Severe sepsis Sepsis resulting in organ dysfunction
Septic shock Sepsis resulting in acute circulatory failure characterized by persistent arterial hypotension

SIRS: systemic inflammatory response syndrome, bpm: beats per minute.

Modified from the article of Levy et al. Intensive Care Med 2003;29:530–8 [11 ] with original copyright holder's permission.