Sepsis, SIRS, MODS Flashcards
What is diagnostic criteria for SIRS in cats?
- ≥ 3 criteria
- High or low temp
- Tachycardia OR Bradycardia
- Tachypnea
- high or low WBCs
What is diagnostic criteria for SIRS in cats?
- ≥ 2 criteria
- High or low temp
- Tachycardia
- Tachypnea
- high or low WBCs
- > 3% bands
What is true about the SIRS criteria for dogs and cats?
Highly sensitive but not specific
What is the definition of septic shock?
- Sepsis induced hypotension that is persistent/refractory despite adequate fluid therapy
What is the host response to SIRS?
Activation of cytokines (cytokine storm)
True or False: Septic patients have SIRS
TRUE
Which of the following should be targeted in a patient with hypotension refractory to fluid therapy?
A. Preload
B. Contractility
C. Systemic vascular resistance
D. Oxygen consumption
C. Systemic vascular resistance
give vasopressors!!
What is a normal lactate value in dogs and cats?
< 2-2.5
Shock is a syndrome where _________
Delivery of O2 is insufficient to meet cellular metabolic needs
What occurs on an oxyhemoglobin dissociation curve in patients with sepsis?
- Sepsis causes a RIGHT shift
- This is an attempt for Hb to deliver O2 to tissues more readily
(Increased metabolic requirements during sepsis)
When are vasopressors indicated for patients with sepsis?
Septic shock / Refractory hypotension despite adequate fluid therapy
When are antibiotics indicated for suspect sepsis patients?
- If 2 criteria of SIRS
- If 3 criteria of SIRS
- Ideally give Abxs within 1 hour of sepsis identification or if highly suspected
What criteria is used to determine if the renal system is affected by MODS?
- Increased Creatinine
- Oliguria UOP < 1-2 mL/kg/hr
What criteria is used to determine if the hepatic system is affected by MODS?
- Increased tbili
- Increased ALT
What criteria is used to determine if coagulation is affected by MODS?
- Increased PT/PTT
- Thrombocytopenia
- Evidence of DIC
What is the 2 hit model? Provide an example
- Primary insult → secondary hit → exaggerated inflammatory response
Ex: Presenting with trauma and later developing secondary aspiration pneumonia
What is the 1-hit model?
- Result of a massive initial insult
- Ex: trauma (HBC), septic peritonitis, heat stroke
What is the sustained hit model?
Continuous smoldering insult causes and sustains MODS
Ex: MDR bacterial infection
What is the most current definition of sepsis?
SIRS + infection + evidence of new organ dysfunction
What are considered end points of resuscitation?
- HR normalizes
- Improved pulse quality
- Lactate clearance
- Normotensive BP
- Normal CRT
In regards to treatment plan in a septic patient, what can negatively impact survival?
Delayed empirical antibiotic treatment
