sepsis Flashcards
what are the SIRS criteria?
- HR greater than 90
- Temperature greater than 38
- RR greater than 20
- WBC
what are the primary sites of sepsis infection?
respiratory tract
intraabdominal space
urinary tract
what is produced in response to invading microorgansims that leads to damage of host tissue?
pro-inflammatory mediators
what is produced to control pro-inflammatory response and actiate leukocytes
anti-inflammatory mediators
what occurs when balance between pro inflammatory and anti inflammatory is lost
SIRS
within the first 6 hours of sepsis what are some common clinical presentations
- fever/ hypothermia
- chills
- mental changes
- tachycardia
- tachypnea/ hypoxia
what are the clinical presentations of late sepsis
- alctic acidosis
- oliguria
- DIC
- hypotension (shock)
what are the goals of therapy for severe sepsis and septic shock
- diagnosis and pathogen ID
- rapid elimination of infectious source
- early initiation of aggressive antimicrobial therapy
- stop pathogenic sequence leading to shock
- avoid organ failure
what are the goals of therapy within first 6 hours of treating sepsis and septic shock
- ventral venous pressure of 8-12
- MAP of 65 or greater
- urine output of .5 ml/kg/hr or greater
- central venous oxygen greater than 70%
what is the fluid challenge in initial resuscitation of septic shock
30ml/ kg of NaCl as long as hemodynamic improvement lasts
what may be considered when substantial amounts of crystalloids (NaCl) are needed during fluid challenge
albumin
when should IV antibiotics be started with sepsis or shock
within first hour of recognizing severe sepsis or shock
when should vasopressor therapy be used for severe sepsis or shock
when MAP is less than 65
what is the initial vasopressor of choice for hemodynamic support of severe sepsis
norepinephrine
if there is low cardiac output, what inotropic therapy can be added for hemodynamic support of severe sepsis
dobutamine
