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Recommendations were first. published as in Critical Care Medicine, Mar 2004. SIRS (Systemic inflammatory response syndrome): The clinical syndrome that results from a deregulated. inflammatory response or to a noninfectious insult. Sepsis: SIRS that is secondary to infection that has been diagnosed clinically. Positive cultures add to the. validity but are not required for the diagnosis. Severe Sepsis: Sepsis plus at least one sign of hypoperfusion or organ dysfunction (see below), that is new, and.