Flashcards in Sepsis Deck (6):
What is sepsis or SIRS?
Systemic inflammatory response syndrome (SIRS)
at least 2 of the following:
1) body temperature less than 36°C or greater than 38.3°C
2) heart rate greater than 90/min
3) respiratory rate greater than 20 breaths per minute
4) blood glucose > 7.7mmol/L in the absence of known diabetes
5) white cell count less than 4 or greater than 12
What causes sepsis or SIRS and what is their relationship?
SIRS may occur as a result of an infection (bacterial, viral or fungal) or in response to a non-infective inflammatory cause, for example burns or pancreatitis. Sepsis is defined as SIRS in response to a proven or presumed infection. The mortality rate of sepsis is around 10%.
What indicates sever sepsis or septic shock?
sepsis with end organ dysfunction or hypoperfusion (indicated by hypotension, lactic acidosis or decreased urine output or others)
severe sepsis with persistently low blood pressure which has failed to respond to the administration of intravenous fluids.
What is the management of sepsis?
Underlying cause of the patients sepsis needs to be identified and treated and the patient supported regardless of the cause or severity. If however any of the red flags are present the 'sepsis six' should be started straight away:
1. Administer high flow oxygen.
2. Take blood cultures
3. Give broad spectrum antibiotics
4. Give intravenous fluid challenges
5. Measure serum lactate and haemoglobin
6. Measure accurate hourly urine output
What are some of the lab finings indicating severe sepsis?
Laboratory and other findings indicating severe sepsis:
- PaO2/ FiO2 ratio 2.0mmol/L
- Bilateral pulmonary infiltrates AND new need for supplemental oxygen to maintain oxygen saturations > 90%
- Creatinine > 176.8µmol/L
- INR > 1.5
- aPTT > 60s
- Platelet count 34.2µmol/L
- Urine output