Fluid Therapy in Dogs and Cats With Sepsis Flashcards
(24 cards)
Define sepsis
Life-threatening organ dysfunction caused by a dysregulated
host response to infection.
What is the mortality rate of septic peritonitis in dogs?
21-68%, 70% with organ failure
What about mortality in cats?
40%
Define septic shock
Subset of sepsis in which particularly profound
circulatory, cellular, and metabolic abnormalities are associated
with a greater risk of mortality than with sepsis alone
What parameters are measured in the SOFA scoring system (7) in humans?
- PaO2/FiO2 ratio
- Platelet count
- MAP
- Total bilirubin
- Creatinine
- Glasgow coma scale
- Urine output
What about qSOFA?
- RR
- Mentation
- SBP
What are the 4 types of pattern
recognition receptors (PRRs)?
1) Toll-like receptors (TLRs):
2) NOD-like receptors
3) The retinoic acid-inducible gene 1 (RIG-
1)–like receptors
4) C-type lectin receptors
Describe PAMPs (pathogen-associated molecular
patterns) function
Those are structures in invading
organisms that serve to identify these organisms as foreign by the body
Describe DAMPs (damage-associated molecular patterns) function
Those are
endogenous molecules, such as mitochondria that are released
or modified by sterile insults, such as trauma
What cells and other sensor systems of the innate immune system express PRRs?
neutrophils,
macrophages, dendritic cells, platelets, complement
system, natural killer cells , fibroblasts, and some
epithelial cells, such as those of the intestinal tract.
Which pro-inflammatory cytokines are produced and secreted by the inflammasome pathway in neutrophils and macrophages?
Interleukin-1beta (IL-1beta) and
IL-18.
What are some mechanisms displayed by neutrophils to kill pathogens?
phagocytosis, the production of reactive oxygen
species, and killing of ingested pathogens by proteases, neutrophil extracellular traps
(NETs)
Define what are neutrophil extracellular traps
(NETs)
Webs of DNA and antimicrobial proteins
designed to kill pathogens and aid in pathogen clearance
What is immunothrombosis?
The interaction between coagulation
and innate immunity that triggers a generalized disseminated
intravascular coagulation (DIC)
How do platelets contribute to organ failure during septic shock?
They actively participate in microvascular
and mitochondrial dysfunction, DIC, acute kidney injury, and cardiac dysfunction
Which cytokines increase is associated with damage endothelial glycocalyx in sepsis?
TNF-a, IL-1b, IL-6, and IL-10
True or False: Evidence suggests that administration of
albumin-containing fluids (e.g., serumalbumin solutions or fresh
frozen plasma) may be protective to the endothelial glycocalyx as
albumin carries erythrocyte-derived sphingosine-1-phosphate to
the endothelium, where it suppressed matrix metalloproteinase
activity
True
How does sepsis affect the myocardial function?
- decreased systolic function –> decreased contractility
- –> diastolic compensation, and the left
ventricular end diastolic volume is increased, which helps to
preserve stroke volume and therefore cardiac output - in some patients, diastolic function is decreased –> higher mortality
What is the first line vasopressor in septic shock and where does it act?
Norepinephrine: a- and b-adrenergic receptors,
although its actions on a-adrenergic receptors predominate,
causing primarily vasoconstriction. This not only increases
arterial vascular tone, but causes venoconstriction as well,
resulting in a decrease in unstressed volume and an increase
in venous return and cardiac output (99). Evidence suggests
that norepinephrine may also improve microvascular flow in
septic shock
In case of decreased systolic function secondary to myocardial dysfunction, what positive inotrope could you use?
Dobutamine
List some clinical signs associated with fluid overload
Increasing body
weight, serous nasal discharge, increased respiratory rate and
effort, peripheral edema, body cavity effusions, chemosis, and
jugular venous distention.
