Sepsis Flashcards
What are the most inflammatory peptides in the complement cascade in sepsis?
C3a, C5a
Which protein covers endothelium and supports an anticoagulant state and helps maintain integrity (tight junction).
Glycocalyx
What are two G-protein-linked GTPases known as?
RHOA and RAC1 - they regulate expression of tight junctions
What’s the function of RHOA?
induces actin filament breakdown and internalizes VE-cadherin, resulting in endothelial barrier breakdown.
What’s the function of RAC1?
Opposite effects to RHOA - stabilizing the actin cytoskeleton and prevents apoptosis
What protein activates RHOA GTPase early in sepsis?
PAR1
What is activated upon underlying collagen exposure?
Williebrand factor
How is the transition from a hypercoagulable state to DIC characterized by?
- Fibrinolysis with increased circulating fibrin degradation products
- Exhaustion of liver-derived prothrombin, fibrinogen, factor X and factor V reserves
Where is procalcitonin produced?
parafollicular cells of the thyroid and by the neuroendocrine cells of the lung and the intestine
What are the 3 main components of the treatment of sepsis?
- Infection control
- Haemodynamic stabilization
- Modulation of sepsis response
What type of antibiotics provide high concentrations in all tissues?
Lipophilic antibiotics - quinolones
What antibiotics stay in extravascular spaces and do not penetrate well into tissues?
Hydrophilic antibiotics - aminoglycosides
For beta lactams what type of dosing is best?
High daily doses by using continuous or extended infusions
For aminoglycosides what type of dosing is best?
Large single daily doses (or extended interval in renal dysfunction)
For quinolones what type of dosing is best?
Higher, albeit spaced out dosing
