lec 15

Question 1

Systemic Inflammatory Response Syndrome (SIRS)

Answer 1

• A clinical response to a nonspecific insult of either infectious or
non-infectious origin
• Defined as 2 or more of the following:
– Temperature: >38℃ or <36℃
– Heart Rate (HR): >90 bpm
– Respiratory Rate (RR): >20bpm or PaCO2 <35 mmHg
– WBC: >12,000/mm3 or <4000/mm3

Question 2

SIRS: A Nonspecific Condition

Answer 2

Inflammation is the body’s response to nonspecific insults that
arise from chemical, traumatic, or infectious stimuli
• Inflammatory cascade is a complex process that involves humoral
and cellular responses, complement, and cytokine cascades.
• Causes can include
– Ischemia
– Inflammation
– Trauma
– Infection
– Multiple insults

Question 3

Sepsis

Answer 3

Systemic response to infection
• Defined as: SIRS + presence of documented infection
• Severe sepsis
– Aforementioned criteria + organ dysfunction, hypoperfusion,
hypotension (systolic BP < 90 mg Hg or decrease 40 mm Hg from
baseline)
• Septic shock
– Persistent hypotension and perfusion abnormalities despite adequate
fluid resuscitation

Question 4

Multiple Organ Dysfunction Syndrome (MODS)

Answer 4

State of physiological derangements in which organ function is
not capable of maintaining homeostasis
• Organ dysfunction with the infection is isolated to a specific
organ, i.e.
– Pneumonia—acute respiratory failure
– Kidney—acute kidney injury

Question 5

Intensive Care Units (ICUs)

Answer 5

Where critically ill patients receive life-supporting care
– Support of one or more organ systems
• Types of ICU’s in Canada
– General medical/surgical ICU’s (MSICU)
– Specialized (i.e. burn, cardiac, neurosurgery, trauma)
– Pediatric and neonatal
• Closed model of care most common

Question 6

Canadian ICU’s

Answer 6

9% mortality rate
• 33% require invasive mechanical ventilation
– Endotracheal intubation
• Non-invasive mechanical ventilation
– i.e. BiPAP