Septic Shock Flashcards
What is defined as hypotension?
Systolic BP
What does MAP stand for? And what is it?
MAP = mean arterial pressure. It’s the average pressure in the arteries during ONE cardiac cycle
What is the 8 letter acronym used to determine a differential diagnosis for shock/hypotension?
END SHOCK = Endocrine, Neurogenic/anaphylactic, Drugs/distributive, Septic, Hypovolemia, Overdose/obstruction, Cariogenic, Kills
What two things are needed to classify a pt having shock?
Infection and SIRS criteria
*SIRS = systemic inflammatory response syndrome
What four criteria make a diagnosis for SIRS?
- Temp >38*C or 90 bpm
- RR >20
- WBC >12,000 K/uL, or 10% immature band form neutrophils
Who is likely to be hospitalized for sepsis: men or women? What age range?
Men are traditionally more likely in ages 85. Highest rate in 85+ age range
What kind of bug causes sepsis 62% of cases? 47% of cases? and 19% of cases?
62% Gram negative, 47% gram positive, 19% fungal
Define sepsis.
A clinical syndrome that results from a dysregulated inflammatory response to infection
Hypotension is relative to what?
Baseline blood pressure
What is hypotension normally associated with?
Organ damage or dysfunction
What is septic shock?
Sepsis presenting with hypotension and organ damage/failure
What is primary MODS? Secondary MODS?
1* = multiple organ dysfunction resulting from a well-defined insult 2* = MOD caused by host's immune response
With MODS, what happens to morbidity as the number of failing organs increases?
More organs involved = higher morbidity
What is cytopathic injury?
Tissue injury due to inflammatory mediators
What are three mechanisms for tissue injury?
Ischemia, Cytopathic injury, and Increased apoptosis
Bacterial pathogens and systemic inflammatory mediators promote what by exaggerating ICAM-1?
epithelial barrier disruption
What happens to chance of morbidity as proinflammatory mediators increase?
the more proinflammatory mediators, the higher chance of morbidity
What happens to survival when you administer antibiotics sooner?
The sooner the pt is on antibiotics, the better chance for survival
What seven things should you be doing to treat sepsis?
monitor tissue perfusion, restore fluids in pt, clean source of infection, re-evaluate therapy
Effective care for septic shock hinges on…?
early recognition, early broad spectrum antibiotics, IV crystalloid resuscitation, and lactate screening
EGDT vs. traditional care - which is better for treating sepsis pts?
No difference, but EGDT costs more money
What is an effective way to treat sepsis caused by LPS, E. coli, or S. aureus?
neutralize TNF in the body
