SIRS, Sepsis + MODS Flashcards
(44 cards)
What is Sepsis?
The systemic inflammatory response to infection involving both proinflammatory and anti-inflammatory responses.
Sepsis is associated with 48,000 deaths in the UK and approximately 30 million cases worldwide, resulting in 6 million deaths.
What are the SIRS criteria?
- Abnormal body temperature (>38 or <36 °C)
- Tachypnea (>20/min or PaCO₂ <32 mmHg)
- Tachycardia (>90/min)
- Leukocytosis (WBC >12,000/mm³) or Leukopenia or Bandemia
SIRS stands for Systemic Inflammatory Response Syndrome.
How is Sepsis diagnosed?
Requires 2 of 4 SIRS criteria + Source of Infection.
Sepsis may be present in the absence of infection.
What are the classifications of Sepsis?
- Severe sepsis: Sepsis with organ dysfunction
- Septic shock: Hypotension persists despite fluid resuscitation
Septic shock can lead to metabolic acidosis.
What are the two stages of septic shock?
- Warm stage: Warm extremities, high pulse rate, high cardiac output
- Cold stage: Cold, moist skin, hypovolemic, low cardiac output
What are the Sepsis 6 interventions?
- Deliver antibiotics
- Take blood cultures
- Measurement of serum lactate
- Administer oxygen
- Fluid resuscitation
- Monitor urine output
These interventions should be delivered within 1 hour of admission.
What is Multiple Organ Dysfunction Syndrome (MODS)?
2 or more organ systems failing to support the body’s needs, often caused by traumatic injury or severe infection.
Sepsis is the most common cause of MODS and is fatal without immediate treatment.
What is the underlying pathophysiology of Sepsis?
Dysregulated inflammation, where inflammation is the primary disease process underlying both SIRS and Sepsis.
Cytokines play a key role in this process.
What are cytokines?
A large group of proteins, peptides, or glycoproteins that serve as signaling molecules secreted by immune cells.
What is the role of cytokines in inflammation?
They bind to specific receptors causing a signaling cascade involved in inflammation, immunity, and haematopoiesis.
True or False: Proinflammatory cytokines promote healing.
False. Proinflammatory cytokines promote inflammation and fight infection.
What happens in the case of cytokine imbalance?
Can lead to tissue and organ damage.
What is oxidative stress?
An imbalance between the production of reactive oxygen species (ROS) and antioxidants, leading to cell damage.
What are reactive oxygen species (ROS)?
Chemically reactive molecules containing oxygen that can lead to cellular damage.
Fill in the blank: The impact on mitochondrial function involves _______ and mitophagy.
Mitochondrial biogenesis
What is the effect of excessive fever in sepsis?
Can cause organ damage.
What is the common presentation of sepsis related to respiratory dysfunction?
Acute respiratory distress syndrome (ARDS).
ARDS is linked to increased mortality.
How does pulmonary circulation impact dysfunction in sepsis?
- High pulmonary arterial pressure
- Pulmonary hypertension
- Decreased gas exchange efficiency
- Severe hypoxaemia
What are the cardiac complications associated with sepsis?
- Myocardial depression
- Ventricular dilation
- Depressed contractility
- Decreased ejection fraction
What cytokines are highly implicated in myocardial depression?
- TNF-α
- IL-1β
What is the effect of proinflammatory cytokines on cardiac function?
They mediate proinflammatory cascades that alter myocardial function.
What happens to calcium handling in systolic dysfunction associated with sepsis?
Decreased calcium transient amplitude and reduced calcium influx.
What is diastolic dysfunction in sepsis associated with?
Impaired relaxation in 20% of septic shock patients.
What ion is associated with myofilaments and altered sensitivity in diastolic dysfunction?
Calcium
Ca2+ is critical for muscle contraction and relaxation processes.
