Sepsis

Question 1

SIRS Criteria

Answer 1

Fever of more than 38°C (100.4°F) or less than 36°C (96.8°F)
Heart rate of more than 90 beats per minute
Respiratory rate of more than 20 breaths per minute or arterial carbon dioxide tension (PaCO 2) of less than 32 mm Hg
Abnormal white blood cell count (>12,000/µL or < 4,000/µL or >10% immature [band] forms)

Question 2

Definition of sepsis

Answer 2

When you think there is an infectious cause for the sepsis and it meets SIRS criteria as well.

Question 3

Definition of severe sepsis

Answer 3

if they meet the criteria for sepsis and have sepsis-induced organ dysfunction or tissue hypo perfusion.
This could present as hypotension, kidney failure, altered mental status or an elevated lactate (traditionally greater than 4 mmol/L).

Question 4

End organ dysfunction defnition

Answer 4

(SBP)<90 mm Hg or mean arterial pressure <70 mm Hg or a SBP decrease >40 mm Hg or <2 SD
below normal for age or known baseline
Creatinine > 2.0 mg/dl (176.8 mmol/L) or Urine Output < 0.5 ml/kg/hour for > 2 hours,
Bilirubin > 2 mg/dl (34.2 mmol/L),
Platelet count < 100,000,
Coagulopathy (INR >1.5 or aPTT >60 secs),
Lactate > 2 mmol/L (18.0 mg/dl)

Question 5

Septic Shock definition

Answer 5

Septic shock is defined as persistently low blood pressure despite the fluid administration. This is typically agreed to be 30 mL/kg.

Question 6

Lactate definition/theory

Answer 6

anaerobic glycolysis during periods of insufficient oxygen delivery