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Clin Chest Med. 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.

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  • 1Division of Pulmonary, Critical Care, and Sleep Medicine, The Warren Alpert Medical School of Brown University, 593 Eddy Street, APC 707, Providence, RI 02912, USA. nicholas_ward@brown.edu


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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