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Flashcards in Sepsis Deck (10)
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1
Q

What is SIRS?

How is it defined?

A

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
Q

What are the causes of SIRS?

A

1: INFECTION

-non-infectious causes of SIRS:
Pancreatitis
Burns
Multiple Trauma
Ischemia
Hemorrhagic shock
3
Q

What is sepsis?

A

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

4
Q

Define severe sepsis

Define severe shock

A
  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
Q

List the following in order of increasing disease severity:

infection, sepsis, septic shock, severe sepsis, SIRS

A
  • INFECTION
  • SIRS
  • SEPSIS
  • SEVERE SEPSIS
  • SEPTIC SHOCK
6
Q

Explain the ‘stranger-danger’ principle:

A

stranger= PAMPs
danger=DAMPs (cell death)

  • -> bind TLRs (innate cells)–> activates:
  • cytokines
  • chemokines
  • adhesion molecules
  • enzymes
  • coagulation factors
  • immunoreceptors
7
Q

What effects to cytokines have?

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

= Sx of inflammation (redness, warmth, pain)

8
Q

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

What cytokine agonists aid in anti-inflammation?

What antiinflmmatory hormones are released?

A
  • IL-4, IL-10
  • IL-1R, TNF-R
  • cortisol
9
Q

How do you treat sepsis?

A
  1. broad-spectrum antibiotics

2. source control

10
Q

What is ‘early goal directed therapy”?

A
  • ensure adequate organ perfusion–> resuscitation in ER within 6 hrs of presentation
  • goal directed bc specific target that indicate ‘near normal’ physiologic funx