Sepsis Flashcards
definition: sepsis
clinical syndrome characterized by systemic inflammatory response to an infectious process
definition: SIRS
systemic inflammatory response syndrome - a response to a physiologic insult manifested by TWO of the following 4 criteria:
- temp over 38 (101.4) or under 36 (96.8)
- HR over 90
- RR over 20 or PaCO2 under 32 mm Hg
- WBC over 12,000, under 4,000, or bandemia over 10%
criteria for sepsis
2 out of 4 SIRS criteria AND suspected or identified infection
definition: severe sepsis
sepsis with evidence of organ dysfunction
definition: septic shock
sepsis AND hypotension despite ‘adequate’ (30 mL /kg) fluid resuscitation
in the US sepsis is recorded in what % of admitted criteria?
2%
what are the host features involved in the pathophysiology of sepsis?
- failure of the immune system to control an initially localized infection
- exaggerated immune and inflammatory response - cellular dysfunction, vasodilation and leaky capillaries
what are the features of sepsis across the different organ systems?
- distributive shock
- myocardial depression
- bone marrow suppression
- activation of clotting cascade (DIC)
- organ dysfunction
what are the most common causes of sepsis?
UTIs
pneumonia
GI infections
when should blood cultures be taken in a patient with sepsis?
before administration of abx
what are the most common gram positive isolates in sepsis?
s. aureus
s. pneumo
what are the most common gram negative isolates in sepsis?
e. coli
klebsiella spp.
pseudomonas aeruginosa
blood cultures are positive in what % of sepsis?
1/3
what is the goal MAP for sepsis?
65 mm Hg
what are the initial fluid of choice for sepsis?
crystalloids
