Sepsis Flashcards
clarification of sepsis
early- up to 3 DOL
late- >3
most common causes of EOS
GBS, E.coli
Mortality 10% (mortality greater in < 37wks)
why are pre term babies more susceptible to mortality with sepsis
don’t receive as many maternal antibodies crossing through placenta
immature cardio/resp
maternal risk factors of EOS
- screening is conducted 35-37wks (20% will be +)
- prev BGS infection (ascending infection)
- maternal fever > 38
- ROM > 18hrs
- pre term delivery
- choiroamnionitis
- lack of maternal care
- multiple courses of prenatal steroids
- mec
suspect chorioaminotis
maternal ferver >38 PLUS FHR> 160 > 10min or increasing WBC or purulent fluid from cervical OS
confirmed chorio
all suspects PLUS \+ gram stain of am fluid low mani glucose high amid WBC ......
complications of corio
NES, funisitis, THOP transient hypothroxianemia of prem, ROP, CP, thyme involution, RDS/BPD
antinatal EOS ris factors
< 37wks < 2500grams 5min apgar < 5 resus twin fetal tachycardia
intrapartum ABX for GBS
IV pen or cefazolin at least 4 hrs before birth
clinda, erythema or taco for pen allergy
risk factors for LOS
vascular access mech vent lack of enteral feeds meds TPN prolonged hospitalization GI tract tract pathology slow weight gain
investigation for EOS
Blood cultures, CBC, CRP
WBC flags in neos
- low (< 5)
- neutrophils < 2
- decreased bands
CRP in neos
c- reactive protein
- < 10mg/dl, can elelvate with any inflammation
Signs of sepsis in clinical findings
ABDs (especially in term babies), lethargy, temp instability, hypotension, glucose instability, increasing fio2 requirements ect
indications for anti-fungal
NP (TPN), LOS, not resolving with empiric
