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7 Cards in this Set
- Front
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definition of sepsis |
sepsis is defined as presence of infection (probable or documented) together with systemic manifestations of infection (blood cultures does not need to be positive) |
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define Severe Sepsis |
=sepsis+ sepsis-induced organ dysfunction or tissue hypoperfusion (hypotention: SBP<90mmHg, MAP<70, or decrease of SBP by 40mmhg, elevated lactate, or oliguria) |
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define Septic Shock |
sepsis induced hypotention persisting despite adequate fluid resuscitation |
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define Systemic Manifestation of Infection (SIRS) |
2 or more of the following:
1.abnormal T>38 <36, 2. HR>90, 3. tachypneoa:RR>20, PaCO2<32, 4. WCC>12000 or <4000 |
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factors associated with increased mortality in Sepsis |
1. lactate level, 2.age is an independant risk factor, 3. hypothermia has higher mortality. |
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early goal-directed therapy |
targets: 1. MAP>=65, 2. urine output>0.5ml/kg/hr 3.ScvO2>=70% 4. CVP=8-12 mmHg
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management of sepsis |
1.fluid resuscitation 30mls/kg Nsaline :aimCVP 8-12mmHg and MAP>65,
2.vasopressors: Noradrenaline
3. measure ScvO2 aim>=70% use PRBC (HT>=30%)and Dobutamine to achieve target
4. maximise Oxygen delivery intubation, mechanical ventilation if hypoxic, acidotic, persistent comrpomise cvs.
5. Antibiotic Therapy in less 1hr,
6. SOurce Control drainage, debridement, percutaneous drainage,
7. other therapies: give hydrocortisone 100mg very ealry if on long term steroids
glucose control: aim bsl 8-10 |
