Tutorial 39 - Sepsis Flashcards
What postoperative complications may occur at POD 1-3 (x2)
wind - atelectasis, pneumonia
What postoperative complications may occur at POD 3-5
water - UTI
What postoperative complications may occur at POD 5-10?
wound - surgical site infection
What postoperative complications may occur at POD 5-7?
walking - DVT
What postoperative complications may occur at POD > 7?
wonder drugs - drug induced fever.
For patients with sepsis and septic shock, what is the recommendation with regards to fluid management?
IV fluids (30ml/kg) within the first hour.
Fluid boluses are preffered method of administration and should be repeated until BP and tissue perfusion are acceptable, pulmonary edema ensues, or there is no further response.
For patients with sepsis and septic shock, fluid management should be guided using what 2 clinical targets? (specific)
MAP 65-70 mmHg
urine output = 0.5 mL/kg/hour.
Following administraiton of fluids and antibiotics in a sepsis/septic shock patients, what lab values should be simultaneously obtained? (x3)
- serum lactate
- ABG
- blood cultures from two distinct venipucture sites and any indwelling vascular access devices.
- urinalysis
- urine c+s
What is the next best step in a septic/septic shock patient who remains hypotensive despite adequate fluid resuscitation (defined as 3L in first 3 hours)?
Vasopressors - initial agent is norepinephrine
What is the definition of sepsis?
Life-threatening organ dyfunction caused by a dysregulated host repsone to infection where organ dysfunction can be measured objectively using tools such as SOFA or qSOFA.
What is the definition of septic shock? (x3 criteria)
Persistent hypotension despite adequate fluid resuscitation
+
initiation vasopressors to maintain MAP >= 65 mmHg
+
Lactate >= 2 mmol/L in the absence of hypovolemia
