Sepsis Flashcards
1
Q
What is the definition of sepsis?
A
- Sepsis is defined as a threatening organ dysfunction caused by a dysregulated host response to infection
- Organ dysfunction can be identified as an acute change in total SOFA score > 2 points consequent to infection
- SOFA score >2 reflects an overall mortality risk of approximately 10% in a general hospital population with suspected infection
2
Q
What is septic shock?
A
- Septic shock can be identified with a clinical construct with persisting hypotension requiring vasopressors to maintain MAP >65mmHg and having a serum lactate of > 2mmol/l despite adequate volume resuscitation
- Patients with septic shock have a hospital mortality of 40%
3
Q
Describe the qSOFA scoring system?
A
Hypotension systolic <100 mmHg
Altered mental status
Tachypnea >22/min
- Score of >2 criteria suggests greater risk
4
Q
How long does a patient with sepsis remain in hospital compared to that of another patient?
A
- The length of stay in hospital is longer with sepsis compared to other conditions
5
Q
What are the body’s defences against sepsis?
A
- Skin, mucosa - epithelial lining
- Innate immune system - IgA in the GI tract, dendrite cells/macrophages
- Adaptive immune system - Lymphocytes, immunoglobulins
6
Q
What is the origin of sepsis?
A
- Originates from a breach of integrity of the host barrier, wether physical or immunochemical
7
Q
What is the pathophysiology of sepsis?
A
- Uncontrolled inflammatory response
Patients with sepsis have features consitent with - Loss of delayed hypersensitivity
- Inability to clear infection
- Predisposition to no-social economic factors
Probable change of sepsis syndrome over time
- Increase in inflammatory mediators
- Shift towards anti-inflammatory immunos
8
Q
Three phases in pathogenesis of sepsis?
A
Release of bacterial toxin
Gram neagtive
- Lipopolysaccharides (LPS)
- Gram positive, Microbial assosciated molecular pattern (MAMP)
