W04_09 Sepsis

Question 1

what does SIRS stand for?

Answer 1

systemic inflammatory response syndrome

Question 2

what’s the definition of SIRS?

Answer 2

T > 38 or < 36.
HR > 90 bpm
RR > 20/min or PaCO2 < 32 mmHg
WBC > 12000 cells/mm3 or < 4000 cells/mm3 or > 10% immature (band) forms

Question 3

causes of SIRS?

Answer 3

INFECTION (mostly);

also: pancreatitis, burns, multiple trauma, ischemia, hemomrrhagic shock

Question 4

what is sepsis?

Answer 4

it’s SIRS, due to infection

Question 5

definition of severe sepsis?

Answer 5

organ dysfunction;
hypotension (sys40 from baseline);
hypoperfusion;

Question 6

what’s septic shock?

Answer 6

severe sepsis with hypotension that won’t respond to fluids and requires pressors

Question 7

what’s the SOFA score?

Answer 7

Sepsis-related Organ Failure Assessment score;

measures resp, CV, liver, renal, thrombosis, neurologic

Question 8

how does infection proceed as disease severity?

Answer 8

infection;
SIRS -> sepsis;
severe sepsis;
septic shock

Question 9

how to treat for sepsis?

Answer 9

broad spectrum antibiotics;
source control;
early goal-directed therapy (e.g. 8-12mm CVP, obtained by fluids or pressors);

Question 10

which organs are most commonly infected in severe sepsis?

Answer 10

lung, abdomen, “others”, urinary tract, soft tissues, IV catheter

Question 11

speed is of the essence in the management of sepsis, and small delays in appropriate therapy increase mortality

Answer 11

okay.

Question 12

what are adjunctive therapies for treating sepsis?

Answer 12

corticosteroids in prolonged shock to supplement HPA axis, target normoglycemia, early enteral nutrition

Question 13

recall that rh activated protein c was taken off the market as sepsis treatment

Answer 13

drug also known as drotrecogin alfa