Sepsis

Question 1

Define sepsis

Answer 1

A life-threatening organ dysfunction caused by a dysregulated host response to infection

Question 2

What is SIRS?

Answer 2

Severe inflammatory response syndrome
A tissue injury secondary to activation of the inflammatory cascade in response to a non-infectious disorder, e.g. acute pancreatitis, ischaemia-reperfusion, or extensive burns. This inflammatory response can be severe but is a regulated and appropriate host response.

Question 3

Define septic shock

Answer 3

Septic shock is a subset of sepsis, with circulatory, cellular and metabolic dysfunction associated with a higher risk of mortality

Question 4

Outline the clinical signs of SIRS

Answer 4

(2 or more of the below);

Temperature > 38 Celsius or < 36 Celsius
HR >90/min
Respiratory rate > 20/min or PaCO2 < 32 mmHg (4.3 kPa)
White blood cell count > 12,000/mm3 or < 4,000/mm3

Question 5

How is a clinical diagnosis of sepsis made?

Answer 5

An acute change in patients SOFA score of >2 points due infection
SOFA = Sequential Organ Failure Assessment. It enables clinicians to establish dysfunction of the core body systems: respiratory (PaO2/FiO2 ratio), haematological (platelet count), liver (bilirubin), cardiovascular (MAP/urine output), neurological (GCS), and renal (creatinine/urine output).