Sepsis Flashcards
Main components of managing sepsis
Resuscitation
Investigation of cause
Definitive therapy
Adjunctive therapy
Target MAP in sepsis?
Greater than 65mmHg
Target urine output in sepsis
Greater than 0.5ml per kg per hour
Fluid resuscitation strategy in sepsis
Boluses of 1L over 30 minutes, repeat as necessary
When should albumin be given in septic patients?
In those with hypoalbuminaemia
Is fluid input-output monitoring useful in sepsis?
Yes, but not for guiding fluid requirements in the first 24 hours, due to capillary leak
What is the vasopressor of choice in sepsis?
Noradrenaline
What are the common sites of sepsis?
Respiratory system
Urinary tract
Abdomen
Also:
Nervous system
Soft tissue infection
Intravascular devices
Identify some forms of source control in sepsis
Drainage of abscesses
Debridement of infected tissue
Removal of infected devices
What length course of antibiotics should a septic patient be on?
In general, 7 to 10 days (guided by clinical response and serum procalcitonin levels)
What blood tests can be used to determine whether a patient has responded to antibiotics?
Serum procalcitonin
Name three antibiotics with poor tissue penetration.
Gentamicin
Vancomycin
Tobramycin
When is dual antibiotic therapy preferable?
Septic neutropenic patients with pneumonia
Patience with multidrug-resistant organisms
Community acquired pneumonia (extended-spectrum beta-lactamase and macrolide)
Do steroids help in septic shock?
Steroids tend to speed up reversal of shock and reduce organ failure
However they do not decreased mortality
How should glucose be controlled in septic patients?
Prevent significant hyperglycemia.
Use an insulin infusion to keep blood glucose between 8 and 10 mmol/L
