Sepsis and Septic Shock

Question 1

Signs of Possible Harmful Systemic Response (SIRS)

Answer 1

2 or more of the ff conditions (may have noninfectional etiology):

FEVER (>38 C) or HYPOTHERMIA (<36 C)
TACHYPNEA (>24 breaths/min)
TACHYCARDIA (HR >90 bpm)
LEUKOCYTOSIS (>12000 mm3) or LEUKOPENIA (<4000 or 10& bands)

Question 2

Sepsis

Answer 2

Sepsis w/ one or more of organ dysfunction:

CVS: arterial BP <90 mmHg or MAP <70 mmHg that responds to administration of IV fluids
RENAL: UO <0.5 mL/kh/hr for 1 hr despite adequate fluids
RESPIRATORY: PaO2/FiO2 <250 (or <200 if lung is the only dysfunctional organ)
HEMATOLOGIC: platelet count <80,000/uL or 50 % decrease in platelet count from highest value recorded over precious 3 days
UNEXPLAINE METABOLIC ACIDOSIS: pH <7.30 or base deficit > 5 mEq/L and plasma lactate level >70 mmHg

Question 3

Septic Shock

Answer 3

sepsis w/ HYPOTENSION (SBP <90 mmHg or 40 mmHg 90 mmHg or MAP >70 mmHg

Question 4

Refractory Septic Shock

Answer 4

septic shock that lasts for > 1 hr and does NOT respond to fluid or pressor administration

Question 5

Multiple Organ Dysfunction Syndrome (MODS)

Answer 5

dysfunction of more than one organ requiring intervention to maintain homeostasis