Intro to Sepsis

Question 1

4 effects of the cytokine storm in sepsis

Answer 1

Systemic vasodilation
Reduced cardiac contractility
Widespread endothelial injury and activation
Systemic activation of clotting cascade (DIC)

Question 2

2 underlying reasons why people die from sepsis

Answer 2

Cytokine storm

Secondary immune dysfunction

Question 3

Sepsis syndrome definition

Answer 3

Suspected or proven infection, in associated with:
Tachycardia, tachypnea, hyper or hypothermia, and dysfunction of 1 or more organs
It is a dysregulated host response

Question 4

qSOFA criteria

Answer 4

2/3 of:
Altered mental status
Fast RR (> 22)
Low BP (< 100)

Question 5

Septic shock definition

Answer 5

Need vasopressors to maintain a MAP of 65 mmHg
AND
Serum lactate level greater than 2 mmol/L in the absence of hypovolemia

Question 6

Initial management of sepsis and septic shock

Answer 6

Within 3 hours of time of presentation:

1. Measure lactate level
2. Obtain blood cultures prior to administration of abx
3. Administer broad spectrum abx (want within 1 hour)
4. Administer 30 ml/kg crystalloid for hypotension or lactate >4 mM

Question 7

What type of solution do we use in sepsis?

Answer 7

Ringer’s lactate (or any other balanced solution)

NOT normal saline

Question 8

Source control

Answer 8

Get rid of the underlying infection!
Surgical intervention when needed
Aggressive supportive care in ICU
Want it within at least 6-12 hours with the least invasive route possible