Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
9 Cards in this Set
- Front
- Back
|
Define the following: 1) Infection 2) Bacteremia 3) SIRS (Systemic Inflammatory ResponseSyndrome) |
1) Infection is the invasion of normally sterile tissue by organisms 2) Bacteremia is the presence of viable bacteria in the blood 3) Need at least 2 of the followingTemp>38oC or <36oC, HR>90, RR>20 WBC>12, 000/mm3 or <4000mm3 or >10% bands |
|
|
Define: 1) Sepsis 2) Severe sepsis
3) Septic shock 4) MODS – Multiple Organ Dysfunction Syndrome |
1) SIRS +source of infection 2) SIRS+Source of infection+organ dysfunction secondary to hypoperfusion (ie SBP<90, SBP drop>40mmHg, Lactic acidosis) 3) Severe sepsis with hypotension despite fluid resuscitation 4) >2 organs involved (eg acute renal failure, disseminated intravascular coagulation, etc ) |
|
|
What are the risk factors for developing sepsis? (5) |
• Bacteremia
• Advanced age (>=65 years) • Immunosuppression • Diabetes and cancer • Genetic factors |
|
|
Systemic Effects of Sepsis (4)
|
• Tissue ischemia
• Cytopathic injury • Apoptosis • Immunosuppression |
|
|
Organ Specific Effects of Sepsis (7)
|
• Heart- myocardial injury
• Circulation- vasodilation • Lung- alveolar injury and edema • Gastrointestinal Tract- ischemia, translocation of bacteria • Liver- ischemia, dysfunction • Kidney- pre-renal injury • Nervous System- encephalopathy |
|
|
Prognostic Factors (5)
|
• Host Response
• Site of infection • Type of Infection • Anti microbial therapy • Restoration of perfusion |
|
|
Principle of Management
|
• Stabilize Respiration
• Assess and restore perfusion • Identify and treat source of infection • Glucocorticoids- treat if suspected to be adrenalinsufficient • Insulin Therapy- no role for tight glucose control |
|
|
Early Goal directed therapy (5)
|
Resuscitation to target the following variables:
•Central venous pressure 8-12 mm Hg •Mean Arterial Pressure (MAP)>=65mm Hg•Urine output >=0.5ml/kg/hour •Central Venous (superior venous oxygen)or mixedvenous oxygen saturation >65%•Normalize lactate value |
|
|
Antibiotics
|
• Broad spectrum antibiotics that can coverboth gram positive and gram negative to start
• Start antibiotics within the first hour of clinicalpresentation • Narrow antibiotic with 48 hours if source orbug is identified. |
