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Flashcards in Sepsis Deck (10):
1

What is SIRS?

How is it defined?

Systemic Inflammatory Response Syndrome

>= 2 of :

-temp >38 or 90bpm
-RR>20/min or PaCO2 12000 cells/mm^3 or 10% immature (band) forms

2

What are the causes of SIRS?

#1: INFECTION

-non-infectious causes of SIRS:
Pancreatitis
Burns
Multiple Trauma
Ischemia
Hemorrhagic shock

3

What is sepsis?

SIRS (severe inflammatory response syndrome) due to proven/probable infection.

4

Define severe sepsis

Define severe shock

1. Severe sepsis:
-organ dysfunction
-hypotension (syst bp 40 from baseline)
-hypoperfusion (lactic acidosis)

2. Septic shock:
-severe sepsis with hypotension that doesn't respond to fluid resuscitation and requires pressors

5

List the following in order of increasing disease severity:
infection, sepsis, septic shock, severe sepsis, SIRS

-INFECTION
-SIRS
-SEPSIS
-SEVERE SEPSIS
-SEPTIC SHOCK

6

Explain the 'stranger-danger' principle:

stranger= PAMPs
danger=DAMPs (cell death)

--> bind TLRs (innate cells)--> activates:
-cytokines
-chemokines
-adhesion molecules
-enzymes
-coagulation factors
-immunoreceptors

7

What effects to cytokines have?

-increase vascular permeability
-increased local blood flow
-infiltration of PMNs, compliment, antibacterial proteins

= Sx of inflammation (redness, warmth, pain)

8

What anti-inflammatory cytokines help keep the immune response local and controlled?

What cytokine agonists aid in anti-inflammation?

What antiinflmmatory hormones are released?

-IL-4, IL-10

-IL-1R, TNF-R

-cortisol

9

How do you treat sepsis?

1. broad-spectrum antibiotics
2. source control

10

What is 'early goal directed therapy"?

-ensure adequate organ perfusion--> resuscitation in ER within 6 hrs of presentation

-goal directed bc specific target that indicate 'near normal' physiologic funx