Sepsis

Definitions

Systemic Inflammatory Response Syndrome (SIRS)

Two or more of the following:

Temp >38 or 100.4 or < 36 or 96.8

Heart rate >90/min

Respiratory rate >20/min or arterial blood PCO2 <32

Leukocyte count >12,000 or <4,000>

Sepsis= SIRS + known infection

Sever sepsis= sepsis associated with organ dysfunction, hypoperfusion, or hypotension

(lactic acidosis, oliguria, acute alteration in mental status)

Septic shock= sepsis-induced hypotension and perfusion abnormalities despite adequate fluid resuscitation

Pathophysiology

Abnormalities of coagulation and fibrinolysis which leads to a procoagulant state

Treatment

Treat the underlying cause, mostly with abx

Activated protein C (Xigris)- MHMC gives with strict precaution due to expense and bleeding tendency, need APACHE (Acute Physiology and Chronic Health Evaluation) score to be >24

Source- Infectious Disease Medicine in MKSAP