SEPSIS/SEPTIC SHOCK Flashcards
It is a subset of sepsis cases in which underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality risk.
Septic Shock
It is a dysregulated host response to infection that leads to acute organ dysfunction
Sepsis
The Sepsis-3 clinical criteria for sepsis include?
1) A suspected infection and
2) Acute organ dysfunction, defined as an increase by two or more points from baseline (if known) on the sequential (or sepsis-related) organ failure assessment (SOFA) score
The most common gram-positive isolates in sepsis?
Staphylococcus aureus
Streptococcus pneumoniae
The most common gram negative isolates?
Escherichia coli
Klebsiella species
Pseudomonas aeruginosa
TRUE OR FALSE:
Pro-inflammatory reactions (directed at eliminating pathogens) are responsible for “collateral” tissue damage in sepsis
It is a common PAMP that is found in the outer membrane of gram-negative bacteria
lipid A moiety of lipopolysaccharide (LPS or endotoxin)
Two of the most commonly affected organ systems in sepsis
respiratory and cardiovascular systems
Respiratory compromise classically manifests as_____?
acute respiratory distress syndrome (ARDS).
It is defined as hypoxemia and bilateral infiltrates of noncardiac origin that arise within 7 days of the suspected infection
* Mild (Pao2/Fio2, 201–300 mmHg)
* Moderate (101–200 mmHg)
* Severe (≤100 mmHg)
Cardiovascular compromise typically presents as _______?
hypotension
TRUE OR FALSE: Arterial lactate is a long-studied marker of tissue hypoperfusion, and hyperlactemia and delayed lactate clearance are associated with a greater incidence of organ failure and death in sepsis.
TRUE
TRUE OR FALSE: For every 1-h delay among septic patients, a 3−7% increase in the odds of in-hospital death is reported.
TRUE
Clinical practice guidelines recommend the administration of appropriate broad-spectrum antibiotics within how many hours of recognition of sepsis or septic shock
1 hour
- 1 HOUR BUNDLE OF CARE
- measurement of serum lactate levels
- collection of blood for culture before antibiotic administration
- administration of appropriate broad-spectrum antibiotics
- initiation of a 30 mL/kg crystalloid bolus for hypotension or lactate ≥4 mmol/L,
- treatment with vasopressors for persistent hypotension or shock
TRUE OR FALSE: Beta lactams may exhibit unpredictable pharmacodynamics in sepsis, therefore continuous infusion is recommended
TRUE
Initial antimicrobial therapy in splenectomized patients with severe sepsis?
Ceftriaxone
