Sepsis and septic shock Flashcards
1
Q
SOFA score >2
A
Overall mortality risk 10% in general hop population
2
Q
Septic shock
A
Sepsis with persisting hypotension requiring vasopressors to maintain MAP >65mmHg
and having a serum lactate of >2mmol/l
mortality 40%
3
Q
3 phases
A
release of bacterial toxins
release of mediators
effects of specific excessive mediators
4
Q
Pro inflammatory mediators
A
promote lekocyte adhesion complement activation vasodilation incr coagulation by release tissue factor and membrane coagulents hyperthermia
5
Q
Anti-inflammatory mediators
A
inhibit TNF alpha
augment acute phase reaction
inhibit activation of coagulation system
neg feedback to pro inflam
6
Q
Features
A
Fever >38 w chills, rigors, flushes, cold sweats Hypothermia <36 esp in elderly and ver young or immunosuppressed Tachycardia Tachypnoea Altered mental state Hyperglycemia Leucocytosis WCC high Leucopenia WCC low High CRP High procalcitonin Hypoxemia Oliguria Coagulation abnormalities incr PT ot APTT Thrombocytopenia Jaundice High lactate
7
Q
Treat
A
oxygen iv fluid challenge blood cultures blood lactate iv antibs monitor urine output
