Sepsis Flashcards
What is sepsis?
Life-threatening organ dysfunction caused by a dysregulated host response to infection
What does sepsis include?
SIRS and infection
What is sepsis usually caused by?
Gram positive bacteria entering the blood and causing a septic state
What does SIRS stand for?
Systemic Inflammatory Response syndrome
What is the criteria for SIRS?
≥ 2 of: • >38°C or < 36°C • Heart rate > 90 • Respiratory rate > 20 • WBC > 12,000/mm³ or < 4,000/mm³
What has replaced SIRS?
qSOFA
What is the qSOFA criteria?
- Respiratory rate >22/min
- Altered mentation
- Systolic blood pressure <100mmHg
What is severe sepsis?
Sepsis that results in organ dysfunction?
What is the criteria for severe sepsis?
- Organ dysfunction
- Hypoperfusion
- Hypotension
- Hyperlactatemia >2mmol/l
- Coagulation dysfunction
- Thrombocytopenia
What is the red flag criteria?
- Acute confusional state
- Systolic B.P <= 90 mmHg (or drop >40 from normal)
- Heart rate > 130 per minute
- Respiratory rate >= 25 per minute
- Needs oxygen to keep SpO2 >=92%
- Not passed urine in last 18 h/ UO < 0.5 ml/kg/hr
- Lactate >=2 mmol/l
- Temp less than 36
How does septic shock start?
Arterial blood pressure drops resulting in organ hypoperfusion
What does organ hypoperfusion lead to?
Blood lactate level rising as organ begins anaerobic respiration
What is severe sepsis?
Sepsis induced hypotension, despite fluid resuscitation
What does someone with severe sepsis require?
Requires vasopressors to maintain MAP >65mmHg
What level is the serum lactate?
Serum lactate >4mmol/l despite adequate fluid volume resuscitation
