SIRS & Sepsis (ch.18) Flashcards
(22 cards)
What does SIRS stand for?
Systemic Inflammatory Response Syndrome
What causes sepsis?
A severe infection caused by bacteria, viruses, fungi, or parasites, and/or toxins.
How is sepsis defined?
A life-threatening organ dysfunction caused by a dysregulated host response to infection
What type of bacteria most commonly causes pediatric sepsis?
Gram-positive bacteria.
Which organisms are common gram-positive causes of pediatric sepsis?
S. pneumoniae, H. influenzae type b, N. meningitidis, and Salmonella
Which is more severe in sepsis: gram-positive or gram-negative infections?
Gram-negative infections are more severe.
What is the most common cause of sepsis in infancy related to malaria?
Plasmodium falciparum.
What is a key physiological sign of pediatric sepsis?
Profound volume depletion with low cardiac output and elevated systemic vascular resistance (“cold shock”)
How is sepsis diagnosed?
- SIRS + confirmed or suspected infection, plus supportive lab data and cultures
- a negative culture does not rule out sepsis
- elevated inflammatory markers (CRP, sedimentation rate, and procalcitonin)
How is severe sepsis diagnosed?
SIRS + either cardiovascular instability and/or ARDS in addition to pulmonary, renal, neurologic, hepatic, or hematologic dysfunction
What defines septic shock?
Sepsis + cardiovascular dysfunction
What are features of warm shock?
Brisk capillary refill, wide pulse pressure, flushed skin, bounding pulses.
What are features of cold shock?
Vasoconstriction, weak pulses, delayed capillary refill, cool extremities, and mottling
What is a hallmark sign of SIRS?
Tachycardia: to compensate for decreased CO
What oxygen goal is set in sepsis management and what is the preferred method for fluid resuscitation?
Maintain oxygen saturation at 95% or higher
IV or IO fluids
What medications are used if fluids are not enough?
Vasoactive agents like epinephrine (used for low bp) and norepinephrine (help maintain bp)
first line tx for shock
Why is ketamine preferred for sedation in septic children?
It increases MAP without reducing CO and has anti-inflammatory effects.
What is the target MAP for infants and children?
55 mm Hg for infants, 65 mm Hg for children
What is the goal central venous pressure (CVP) in sepsis?
5–10 cm H₂O
What is the goal SvO₂ in septic patients?
Greater than 70%
What does a high SvO₂ indicate in sepsis?
Poor tissue oxygen extraction due to blood flow maldistribution
What treatment is used for refractory septic shock?
ECMO
