Sepsis (Barker)

Question 1

What are the 4 mechanisms of organ failure in sepsis?

Answer 1

• hypoperfusion = #1
• poor oxygen utilization / metabolism
• coagulopathy
• apoptosis.

Question 2

What are the two most important therapeutic responses in a septic patient?

Answer 2

1- optimize perfusion with fluid and maybe vasopressors if needed

2- treat the infection. Drain the cut if needed. Start antibiotic therapy ASAP.

Question 3

Define SIRS (systemic inflammatory response syndrome) / Sepsis: Give the 4 criteria.

Answer 3

2 of the 4 needed for diagnosis of SIRS.

• temp >38C or 90bpm
• resp rate >20/min or paCO2 12,000 or band forms >10%
• WBC 12,000

Question 4

Define severe sepsis

Answer 4

Severe sepsis = SIRS/ sepsis + evidence of hypoperfusion, hypotension, or organ failure in at least 1 organ.

Question 5

Define refractory septic shock

Answer 5

hypotension despite vasopressor use.

Question 6

Define septic shock

Answer 6

Severe sepsis plus one of the following

• ongoing hypotension despite volume resuscitation
• need for vasopressors to maintain BP