A nurse is explaining the pathophysiology of systemic inflammatory response syndrome (SIRS) to a group of newly licensed nurses. Which of the following statements by the nurse is accurate?

Systemic inflammatory response syndrome (SIRS) is driven by a dysregulated immune response in which the body releases an excessive and uncontrolled flood of pro-inflammatory cytokines — often called a cytokine storm. This leads to widespread endothelial damage, vasodilation, increased vascular permeability, and ultimately multi-organ dysfunction. The statement that a deregulated cytokine storm causes an inflammatory response is accurate and reflects the core pathophysiology of SIRS. The option claiming spleen dysfunction causes blood clotting issues is incorrect; while coagulopathy can occur in SIRS and related conditions like disseminated intravascular coagulation, this is not caused by the spleen but rather by depletion of clotting factors and platelet consumption. The statement that activation of the inflammatory cascade causes increased perfusion is the opposite of what occurs — SIRS results in maldistribution of blood flow and decreased effective perfusion to organs, not increased perfusion. Finally, while SIRS can injure multiple organs, the organ most prone to injury is typically the lungs (causing acute respiratory distress syndrome) and the kidneys, not the heart, making that distractor inaccurate. Students should remember that cytokines such as TNF-alpha, interleukin-1, and interleukin-6 are central mediators in SIRS pathophysiology.