Sepsis Flashcards
def. or SIRS
2 of:
- fever
- HR > 90
- RR > 20
- WBC > 12000
causes of SIRS
INFECTION
- pnacreatitits, burns, multiple trauma, ischemia
def. sepsis
SIRS due to proven infeciton
def. severe sepsis
sepsis with evidence of organ dys, hypotension, hypoperfusion
def. septic shock
severe sepsis with hypotension that has not responded to fluid and requires pressors
what does innate immune system respond to
stranger danger (PAMPs and DAMPs)
what does TLR binding initiatite
cytokines, chemokines, adheions molecules, enzymes
what is vasc. response to infection
increased vasc. permeability, local blood flow, PMN infiltration —- inflammation
what is other response that is activated
anti-inflammatory response to contain the inflammation
what is anti-inflammatory response
IL-4 and 10, inhibs. PMN adherence, cortisol, gives a por-coagulant respnse to limit spread of pathogens
what occurs in sepsis
anti-inflammatory response is overwhelmed and pro-inflammtory cells spread to involve normal tissues
what is problem with vasc. perm.
hypotension, ARDS
what is prob. with platelet adherence
DIC, thrombosis
prob. with vasodialtion
hypoxia at other site, lactic acidosis
prob. with anti-inflammatory mediators
net state of immuno-supression
