Multiorgan Failure Flashcards

1
Q

Bacteraemia

A

Presence of viable bacteria in the blood stream

Will have a transient bacteraemia after brushing your teeth

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2
Q

Sepsis

A

Two or more signs of a systemic inflammatory response with evidence of infection

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3
Q

Severe Sepsis

A

Sepsis with organ dysfunction

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4
Q

Septic Shock

A

Sepsis with hypotension requiring inotropes

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5
Q

Systemic inflammatory response

A

Temp –> >38C or >90 beats per min

Resp Rate –> >20 breaths per min or PaCO2 12,000 cell/mm3

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6
Q

Multiple organ failure

A

Systemic inflammatory response PLUS:
Acute lung injury or ARDs
Encephalopathy
Hypotension unresponsive to fluids +- inotropes
DIC with INR >1.3 or platelets 2mmol/L) or metabolic acidosis
Oligouria or abnormal liver function +-GI dysfunction

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7
Q

Treatment of Multi-organ failure

A

Supportive –> culture then drain infection/abx
Oxygen +- ventilation –> fluid resuscitation/vasopressors
Haemofiltration and Nutritional support
Prevent the development of further complications

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8
Q

Gut directed therapy

A

Use fluid resuscitation and monitor splanchnic perfusion
May use Sucralfate and splanchnic vasodilators
Consider maintaining enteral nutrition
Selective decontamination of the digestive tract

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9
Q

Enteral nutrition

A

Pros –> Physiological, cheap, protects gut integrity and increases blood flow
Cons –> aspiration, bowel dilation, diarrhoea and constipation

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10
Q

Parenteral nutrition

A

Pros –> Calorifically complete, less risk of mal-absorption, may be lifesaving,
Cons –> Requires central line, expensive, mucosal atrophy, immunosuppressive

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11
Q

Prevention of sepsis

A

Have a low threshold for calling for help
Careful monitoring of high risk patients
Early detection of deterioration
Timely intervention with fluids, antibiotics, oxygen

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12
Q

Signs of developing sepsis

A

Systolic BP 25/min
HR 110/min or O2 sats 40% FiO2
Urine <100ml in 4hrs or Drop in GCS

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