Figure 2.

Systemic inflammatory response (SIRS) and compensatory immune tolerance in trauma (CARS). Schematic diagram shows that once trauma has occurred, a primary systemic pro-inflammatory response (SIRS) is initiated which can contribute to early multi-orgn failure (MOF). The compensatory immune tolerance or anti-inflammatory response syndrome (CARS) can begin while the pro-inflammatory SIRS is still present. At the later phase CARS can lead to immune paralysis and following that, late multi organ failure [This figure is adapted from Hietbrink et al. (23)].