Terry White, MBA, BSN SEPSIS

SIRS Systemic Inflammatory Response System SIRS is a widespread inflammatory response to a variety of severe clinical injuries. This syndrome is clinically indicated by the presence of 2 or more of the following Temp >38%C or <26%C HR > 90/min RR > 20/min or PaCO2 <32mm/HG WBC >12 or 10% immature band forms

Sepsis In sepsis, the clinical signs of SIRS are present together with the definitive evidence of infection

SEVERE SEPSIS Severe Sepsis Sepsis is considered severe when it is associated with organ dysfunction, hypoperfusion, or hypotension The manifestations of hypoperfusion may include lactic acid, oliguria, and an acute alteration in mental status

SEPTIC SHOCK Septic Shock Is sepsis with hypotension despite adequate fluid replacement combined with perfusion abnormalities that may include Lactic acidosis Oliguria Acute alteration in mental status Patients who require inotropic or vassopressor support despite adequate fluid replacement are in septic shock

MODS Multiple Organ Dysfunction Syndrome Refers to the presences of altered organ function in an acutely ill patient such that homeostasis cannot be maintained without intervention

RISK FACTORS Extreme age ( 65yrs) Malnutrition Hypothermia Use of Central line catheters Endotracheal intubation/mechanical ventilation Aspiration Chronic illness (Diabetes, RF, Hepatic failure) Immunodeficiency (AIDS, Alcoholism, chemo) Use of surgical/invasive procedures

TREATMENT POSSIBLE TREATMENTS Fluid replacement Control of blood pressure Tissue perfusion Early treatment with antibiotics Administration of steroids for adrenal insufficiency Control of glucose levels Protective lung ventilation Administration of activated protein C