{"id":10273,"date":"2022-01-28T11:26:49","date_gmt":"2022-01-28T09:26:49","guid":{"rendered":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/infectology\/sepsis\/"},"modified":"2022-02-02T23:43:03","modified_gmt":"2022-02-02T21:43:03","slug":"sepsis","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/infectology\/sepsis\/","title":{"rendered":"Sepsis"},"content":{"rendered":"\n

Definitions<\/h4>\n<\/span>\n\n\n
  • Systemic inflammatory response syndrome <\/strong>(SIRS). An exaggerated reponse of the body to noxia (infection, trauma, ischemia, surgery). Clinically defined as two of the following:
    • Body temp.: <36 \u00b0C, or >38 \u00b0C<\/li>
    • Heart rate: >90\/min<\/li>
    • Breathing frequency 20\/min, PaCO2<32 mmHg<\/li>
    • WBC count: <4 G\/l or >12 G\/l, or more than 10% immature forms<\/li><\/ul><\/li>
    • Sepsis<\/strong>. SIRS associated with an infection (most often Gr+, arising from pneumonia, UTI, meningitis, peritonitis, etc)<\/li>
    • Septic shock<\/strong>. Sepsis-induced shock (circulatory collapse) presenting as hypotension despite of volume replacement. The most common cause of death in the ICU.<\/li>
    • Multiple organ dysfunction syndrome (MODS)<\/strong>. Acute dysfunction of two or more organs<\/li><\/ul>\n\n\n<\/span>\n

      Pathophysiology<\/h4>\n<\/span>\n\n\n
      • Circulatory collapse due to systemic vasodilation, caused by elevated lactic acid levels and acidosis, ADH depletion, and endothelial secretion of NO.<\/li>
      • CO is normal\/increased, tachycardia is evident<\/li><\/ul>\n\n\n<\/span>\n

        Clinical presentation<\/h4>\n<\/span>\n\n\n
        • Infection signs (penumonia, UTI, meningitis, peritonitis, etc)<\/li>
        • Fever\/hypothermia (usually in the young\/elderly)<\/li>
        • Hypotension, tachypnea, tachycardia, oliguria, lactic acidosis<\/li>
        • Signs of organ dysfunction in severe sepsis<\/li><\/ul>\n\n\n<\/span>\n

          Organ dysfunction<\/h4>\n<\/span>\n\n\n
          • Renal: oliguria, anuria; increased Scr<\/li>
          • Liver: icterus; hyperbilirubinemia, ALT, AST, LDH, AP elevated, hypoalbuminemia<\/li>
          • Cardiovascular: tachycardia, arrhythmia, hypotension, heart failure<\/li>
          • Hematological: DIC<\/li>
          • GI: bleeding, ileus, acute abdomen, pancreatitis<\/li>
          • CNS: confusion, psychosis<\/li>
          • Endocrine: weightloss, hyperglycemia, TGA increase, hypoalbuminemia<\/li><\/ul>\n\n\n<\/span>\n

            Scoring system<\/h4>\n<\/span>\n\n\n

            The SOFA score is a scoring system for outcome prediction and risk stratification, which uses the Glasgow coma scale, along with evaluations of CV, respiratory, coagulation, liver, and renal functions. qSOFA score is a simplified version consisting of hypotension, tachypnea, and altered mental status (GCS<15).<\/p>\n\n\n<\/span>\n

            Diagnosis<\/h4>\n<\/span>\n\n\n
            • Based on the clinical signs<\/li>
            • Blood chemistry (lactic acid >2mmol\/L)<\/li>
            • Acute-phase reactants (procalcitonin, IL-6)<\/li>
            • Cultures<\/li><\/ul>\n\n\n<\/span>\n

              Treatment<\/h4>\n<\/span>\n\n\n
              • Fluids (30ml\/kg bolus)<\/li>
              • Empirical antibiotic therapy (piperacillin\/tazobactam) until the source is diagnosed<\/li>
              • Vasopressors (NE, vasopressin, phenylephrine)<\/li><\/ul>\n<\/span>

                Definitions<\/h4>

                Pathophysiology<\/h4>

                Clinical presentation<\/h4>

                Organ dysfunction<\/h4>

                Scoring system<\/h4>

                Diagnosis<\/h4>

                Treatment<\/h4><\/div>","protected":false},"excerpt":{"rendered":"

                Definitions Systemic inflammatory response syndrome (SIRS). An exaggerated reponse of the body to noxia (infection, trauma, ischemia, surgery). Clinically defined as two of the following: Body temp.: <36 \u00b0C, or >38 \u00b0C Heart rate: >90\/min Breathing frequency 20\/min, PaCO2<32 mmHg WBC count: <4 G\/l or >12 G\/l, or more than 10% immature forms Sepsis. SIRS […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":10247,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-10273","page","type-page","status-publish","hentry"],"yoast_head":"\nSepsis – Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/infectology\/sepsis\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" 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