MICU Intern's survival guide sepsis: Difference between revisions
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===Source control=== | ===Source control=== | ||
* Depending on the patient's history sputum, blood, urine or any other source can be culture. In case of unclear source, pan-culture should be done. | * Depending on the patient's history sputum, blood, urine or any other source can be culture. In case of unclear source, pan-culture should be done. | ||
* Based on the patient's history proper imaging should be initiated. | |||
===Resuscitation=== | ===Resuscitation=== | ||
Revision as of 02:45, 23 December 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Sepsis Microchapters |
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Diagnosis |
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Treatment |
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MICU Intern's survival guide sepsis On the Web |
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Risk calculators and risk factors for MICU Intern's survival guide sepsis |
Overview
Systemic Inflammatory Response Syndrome[1][2]
- SIRS can be diagnosed when two or more of the following are present:[3]
- Heart rate > 90 beats per minute
- Temperature < 36 (96.8 °F) or > 38 °C (100.4 °F)
- Tachypnea > 20 breaths per minute or, on blood gas, a PaCO2 < 32 mm Hg
- White blood cell count < 4000 cells/mm³ or > 12000 cells/mm³ (< 4 x 109 or > 12 x 109 cells/L), or > 10% band forms (immature white blood cells / bandemia).
- SIRS can be seen in non infectious conditions like pancreatitis and myocardial infarction.
Sepsis
- SIRS + Source of infection
Severe sepsis
- Sepsis + organ dysfunction
- Organ damage can present as decreased urine output, acute kidney injury, and elevated liver function tests.
Septic shock
- Severe sepsis + persistent hypotension after adequate fluid challenge.
Multiple organ dysfunctions (MODS)
- Progressive multiple organ failure secondary to severe sepsis.
Sepsis management
Source control
- Depending on the patient's history sputum, blood, urine or any other source can be culture. In case of unclear source, pan-culture should be done.
- Based on the patient's history proper imaging should be initiated.
Resuscitation
References
- ↑ Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R, Calandra T, Dhainaut JF, Gerlach H, Harvey M, Marini JJ, Marshall J, Ranieri M, Ramsay G, Sevransky J, Thompson BT, Townsend S, Vender JS, Zimmerman JL, Vincent JL (2008). "Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008". Critical Care Medicine. 36 (1): 296–327. doi:10.1097/01.CCM.0000298158.12101.41. PMID 18158437. Retrieved 2012-09-16. Unknown parameter
|month=ignored (help) - ↑ Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992 Jun;101(6):1644-55. PMID 1303622.
- ↑ Tslotou AG, Sakorafas GH, Anagnostopoulos G, Bramis J. Septic shock; current pathogenetic concepts from a clinical perspective. Med Sci Monit. 2005 Mar;11(3):RA76-85. PMID 15735579. Full Text.