Sepsis

Sepsis is a topic covered in the Pocket ICU Management.

To view the entire topic, please or purchase a subscription.

Anesthesia Central is an all-in-one web and mobile solution for treating patients before, during, and after surgery. This collection of drug, procedures and test information is derived from Davis’s Drug, MGH Clinical Anesthesia Procedures, Pocket Guide to Diagnostic Tests, and MEDLINE Journals. Explore these free sample topics:

Anesthesia Central

-- The first section of this topic is shown below --

First Things First (assess & treat for the following)

  • IF A PT IS IN SHOCK, RESUSCITATE & SUSTAIN THE ABCs FIRST, THEN ASCERTAIN THE ETIOLOGY AFTER TREATMENT IS INITIATED!
  • Sepsis is the leading cause of death in noncardiac ICUs.
  • Does pt have sepsis?
    • Systemic inflammatory response syndrome (SIRS) criteria
      • Temperature: >38C or < 36C
      • Heart rate: >90 beats/min
      • Respiratory rate: >20 breaths/min or PaCO2 < 32 mmHg
      • WBC: >12,000 or < 4,000 cells/mm3
    • Two or more criteria = SIRS
    • SIRS caused by infection = sepsis
  • Does pt have septic shock?
    • Sepsis-induced hypotension present?
      • SBP < 90 mmHg or MAP < 60 mmHg
    • No response to fluid resuscitation or requirement of vasopressors to maintain BP
    • Perfusion abnormalities present
      • Lactic acidosis
      • Oliguria
      • Altered mental status
  • Is multiple organ dysfunction syndrome (MODS) present?
    • Cr >1.5 mg/dL
    • Elevated AST, ALT, alk phos, or bilirubin
    • Heart failure
    • Respiratory failure
    • Mental status changes
  • SIRS may progress to MODS in the absence of infection.
    • Differential diagnosis
      • MI, PE, pancreatitis, burns, anaphylactic reaction, toxic shock syndrome, drug overdose or poisoning, hypothermia, delirium tremens, transfusion reaction, cardiac tamponade, UGI bleed, acute adrenal insufficiency

-- To view the remaining sections of this topic, please or purchase a subscription --

Last updated: May 3, 2010