Sepsis/Septic Shock Flashcards
What is sepsis
Systemic response to infection leading to organ failure and death
What is septic shock?
Subset of sepsis in which underlying circulatory and cellular/metabolic abnormalities are profound and increase motility.
How is organ dysfunction determined?
SOFA score
What are the components to a SOFA score? (7)
PaO2 Platelets Bilirubin MAP GCS Cr Urine output
A SOFA score of >/= ____ reflects an overall mortality risk of 10% in a hospitalized patient.
2
Components of qSOFA?
RR >/= 22
GCS <13
SBP = 100
Severe sepsis disrupts homeostasis by what 4 mechanisms?
Inflammation activation
Coagulation activation
Fibrinolysis suppression
Coagulopathy
What are activated in sepsis that increase inflammation?
TNF, interleukins, and platelet activating factor
Signs of inflammation?
Redness - Rubor
Heat -Calor
Swelling -tumor
Pain -dolor
What interleukins down regulate the initial proinflammatory response?
IL4 and IL10
What interleukins released cause tissue and capillary injury in cytokine storm?
IL1 and IL6
What is the key inhibitor of fibrinolysis that has increased activity in sepsis?
Plasminogen activator inhibitor-1
PAI-1
What metabolite is increased as a result of sepsis?
Lactic acid (lactate) is a byproduct of bacterial metabolism
Lactate of > ___ is concerning for sepsis.
4
A goal in treatment of sepsis is to decrease lactate to
5