Lec 23 Grand Rounds on Sepsis Flashcards
Severe inflammatory syndrome that has a proven or suspected microbial etiology
Sepsis
Prolonged capillary refill as a criteria for severe sepsis means it is longer than how many seconds
5 seconds
Severe sepsis is sepsis plus which of the following?
a. Cardiovascular organ dysfunction
b. Acute respiratory distress syndrome
c. Multiple chancroids
d. AOTA
e. A & B
e. A & B
What is septic shock?
Sepsis plus persistent cardiovascular organ dysfunction
What happens to the skin of a neonate experiencing decreased delivery of oxygen and consequently hypoperfusion of organs?
Mottling
One evidence of inflammation is that immature to total neutrophil ratio must be:
> 0.2
Diagnostic tests which can supply evidence for multiorgan system disease?
- Arterial blood gas analysis (metabolic acidosis and pulmonary function)
- blood chemistry
- renal function test
- hepatic function
Initial empiric therapy for early-onset bacterial infection in neonates:
ampicillin + aminoglycoside
T/F: The rational use of antibiotics in neonates involves using narrow spectrum of drugs to treat the infection and not colonization, limiting the duration of therapy
T
Test to distinguish neonatal pneumonia and sepsis from each other?
Blood culture
Presence of bacteria in blood, as evidenced by positive blood cultures
bacteremia
To be considered severe, sepsis must be accompanied by ____ % decrease in platelet count from highest value recorded over previous 3 days.
50%
Refractory septic shock is septic shock that lasts for more than:
1 hour and does not respond to fluid or pressor administration
stimulates leukocytes and vascular endothelial cells to release other cytokines, to express cell-surface molecules that enhance neutrophil-endothelial adhesion at sites of infection and to increase prostaglandin and leukocyte production
TNF-alpha
Hallmark of septic shock
decrease in peripheral vascular resistance that occurs despite increased levels of vasopressor catecholamines.
