Sepsis

Question 1

What is Sepsis

Answer 1

Sepsis is a potentially life-threatening complication of an infection. Sepsis occurs when chemicals released into the bloodstream to fight the infection trigger inflammatory responses throughout the body.

Question 2

Explain the pathophysiological changes for sepsis

Answer 2

• Sepsis is a common condition in which the body over reacts to a severe infection.
• in sepsis, the balance between activation and down regulation of the inflammatory response fails, leading to unregulated coagulation, localised ischaemia, shock and organ failure
• As sepsis progresses, widespread inflammation leads to alterations in the coagulation system, allowing blood to clot when it would normally flow well within vessels
• This leads to the formation of microthrombi, reduced blood flow, poor tissue perfusion, reduced oxygendelivery and organ dysfunction
• Eventually, localised inflammation becomes overwhelming, leading to a systemic reaction, multiple organ damage and haemodynamic compromise

Question 3

Treatment of sepsis and why

Answer 3

• Fluid resuscitation is the first priority for patients with severe sepsis or septic shock, with fluid replacement compensating for the hypoperfusion and third spacing caused by vasodilatation. Intravenous fluids aim to increase circulating volume in order to maintain perfusion pressure and avoid organ dysfunction.
• oxygen treatment is also important, as septic patients have increased oxygen demands due to the increase in metabolism together with hypoperfusion and localised ischaemia from increased coagulation.