Sepsis Organ Effects

Question 1

how does sepsis affect the cardiovascular system?

Answer 1

widespread vasodilation leading to hypotension and fall in total peripheral resistance

Question 2

how can cardio effects of sepsis be managed?

Answer 2

fluid resuscitation +/- inotropes +/- vasoconstrictors

Question 3

how does sepsis affect the pulmonary system?

Answer 3

endothelial injury in lung tissue/capillary leak
diffuse alveolar oedema
resp failure (needing supplemental oxygen)

Question 4

how does sepsis affect the kidneys?

Answer 4

acute kidney injury due to hypoperfusion

Question 5

how might acute kidney injury in sepsis present?

Answer 5

rise in urea/creatinine

oligo-aneuria (<100ml urine passed per day)

Question 6

how can sepsis affect the liver?

Answer 6

“shock liver”

- transaminitis +/- jaundice due to hepatocyte injury

Question 7

how does transaminitis present?

Answer 7

grossly elevated ALT/AST

Question 8

how can sepsis affect the CNS?

Answer 8

delirium/acute confusional state due to diffuse cerebral hypoperfusion/dysfunction
can become drowsy/decreased consciousness level

Question 9

how can sepsis affect the haematological system?

Answer 9

disseminated intravascular coagulation

consumptive coagulopathy due to endothelial dysfunction/platelet aggregation and coagulation cascade activation

Question 10

how is consumptive coagulopathy evidenced?

Answer 10

low platelets
prolonged APTT/PT
low fibrinogen and fragments on film

Question 11

how can sepsis cause lactic acidosis?

Answer 11

diffuse tissue hypoperfusion/hypoxia > anaerobic metabolism leads to lactic acid production > metabolic acidosis > acidosis worsens cardiovascular stability