Sepsis Flashcards
Define sepsis and septic shock.
Sepsis: Body’s life-threatening host response to infection that can lead to tissue damage, organ failure, and death
Septic shock: a life-threatening form of sepsis (can be result of severe sepsis) usually due to presence of bacteria and their toxins in the bloodstream. Characterized especially by decreased blood flow to organs and tissues, hypotension, organ dysfunction, and often multiple organ failure
List risk factors for sepsis.
Name four key causative pathogens of sepsis.
- Neisseria meningitidis
- Streptococcus pneumoniae
- Streptococcus pyogenes
- Encapsulated organisms (for asplenics)
Define colonisation.
• Colonisation - presence of a microbe in the human body that does not cause infection or a specific immune response
Define infection.
• Infection - occurrence of inflammation due to the presence of a microbe
Define septicaemia.
• Septicaemia - presence of viable microbes in the blood (can be bacteraemia, viraemia, parasitaemia)
Describe the criteria for sepsis.
Briefly explain the pathophysiology of sepsis.
- Infection
- Host defense mechanism activation
- Influx of Activated neutrophils & monocytes
- Release of inflammatory mediators
- Vasodilation and Activation of coagulation
- Diffuse endothelial dysfunction (Driver of most symptoms of sepsis)
- Increased endothelial permeability
Describe the set of interventions/investigations necessary for management of sepsis.
BUFALO
- Take Blood cultures
- Measure accurate hourly Urine output
- Give intravenous Fluid challenges
- Give broad spectrum Antibiotics
- Measure serum Lactate and haemoglobin
- Administer high flow Oxygen.
How much can you increase the patient’s chances of survival by performing BUFALO in the first hour ?
By carrying these out in the first hour, you can double your patient’s chance of survival!
Identify the investigations appropriate to the diagnosis and management of sepsis.
- Blood tests: WCC (could be increased or decreased in sepsis), CRP (always present in infection), platelets, clotting
- Microbiology: Culture (blood, stool, urine, wound swab, tissue, CSF, sputum)
- Viral studies: e.g. NAAT / PCR
- Serology: for antibodies
Describe the treatment options for sepsis.
Blood cultures before prescribing!! (so have baseline to compare with after giving IV antibiotics)
Review once microbiology results available!
• IV antibiotics within 60 minutes of recognition of sepsis (even if suspect viral infection)
• IV fluids
• Oxygen
• Vasopressors
List a few conditions which may cause sepsis.
Meningitis
Pneumonia
UTIs
Septic arthritis
Features of inflammatory responses
What happens in localised regulated inflammation
Toll-like receptor (TLRs) on most immune cells surface
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What is TLR4
What is TLR3
What do activated TLRs regulate
What is SIRS
What happens in a dysregualted inflammation (SIRS/sepsis)
What are the mitochondria functions
What is generated across the inner mitochondrial membrane
What happens in a mitochondrial dysfunction (sepsis)
What are the impacts of dysregulated inflammation on mitochondria
Why mitochondria is considered as “quality control” in sepsis
Waht happens in a proposed mitochondria/cell hibernation
What are the presentations of sepsis
Clinical finding of sepsis
table
what are the risk assessment for sepsis
What is qSOFA
Receiver Operating Curve (ROC) and Area Under Curve (AUC)
