Week 7: Sepsis

Question 1

Who develops sepsis?

Answer 1

Mostly in community and long term care facilities
Very old and very young
Immunocompromised
Co-morbidities: diabetes, HF, other chronic illnesses

Question 2

What is the progression of sepsis?

Answer 2

Infection –> systemic inflammatory response syndrome –> sepsis –> septic shock –> multiorgan dysfunction syndrome

Question 3

What is systemic inflammatory response syndrome?

Answer 3

Response to:
Microbial invasion
Tissue trauma: burns, crush, surgery
Ischemic or necrotic tissue
Endotoxin release
Perfusion deficits

Question 4

What are the criteria for systemic inflammatory response syndrome?

Answer 4

Two or more:
Temp: <36 or > 38
HR: >90 BPM
RR: > 20 or PaCO2 32 mmHg
Altered mental state
BGL > 7.7 mmol/L without diabetes
WCC > 12 or < 4

Question 5

What is sepsis?

Answer 5

Organ dysfunction resulting from dysregulated response to infection

Question 6

What is septic shock?

Answer 6

Subset of sepsis in which circulatory, cellular and metabolic alterations are associated with higher mortality than sepsis

Question 7

What is a sequential organ failure assessment?

Answer 7

Two of the following:
SBP < 100 mmHg
GCS < 12
RR > 22
PaO2/FiO2 ratio
Urine output

Question 8

Include patho

Answer 8

blank

Question 9

How does sepsis affect the heart?

Answer 9

Vasodilation –> decreased systemic vascular resistance –> low afterload –> low BP
Vasodilation –> warm peripheries
Increased capillary permeability and fluid shift into interstitial space –> decreased preload
Baroreceptor detects low BP –> tachycardia