Abstract
In the early phase after clinical insults (planned and unplanned injuries), both local and systemic inflammatory responses occur in the body. These are biological defense responses to insults. These responses are indispensable for the survival of organisms and therefore, have delicate backup, fail-safe, and feedback systems. The activation of the feedback system for locally-induced proinflammatory cytokines results in the predominance of anti-inflammatory cytokines in the systemic circulation. The more marked local inflammatory responses are, the more severe systemic anti-inflammatory responses become. To understand the vulnerable state of organ failure after insults, the author proposes to classify the pathologic condition after insults into SLIRS (systemic and local inflammatory response syndrome) in the early phase and LISIS (local inflammation-induced systemic immunosuppression syndrome) in the subsequent phase to avoid confusion with previous held concepts of SIRS (systemic inflammatory response syndrome) and CARS (compensatory anti-inflammatory response syndrome). The development of post-insult organ failure should be considered in terms of the course with time and both local and systemic states. Uniform measures for mediators are inadequate.