| A | B |
|---|
| Signs and symptoms of poor perfusion | cool, sometimes mottled, extremities, oliguria, confusion |
| Characteristics of sepsis | presence(or suspected presence) of an infection, signs of a strong host response, hypotension, signs and symptoms of poor perfusion |
| SIRS entails these parameters | T - <36 or >38; HR - > 90; RR - 20 or pCO2 <32; WBC - <4 or >12 |
| Sepsis includes these... | two or more SIRS and an infectious source |
| Severe Sepsis includes these... | Sepsis with signs of failure in at least one organ system |
| Septic Shock includes these... | Sepsis with shock/hypoperfusion despite fluid resuscitation |
| This is the biggest sepsis source among patients arriving from the community... | Respiratory (second only to UNKNOWN) |
| Physiology of hypotension in sepsis... | Initially mast cell degranulation, then persistent vasodilation, leading to increased intravascular volume and relative hypovolemia |
| Laboratory evidence of organ ischemia... | elevated liver enzymes, elevated creatinine, elevated troponin |
| What is the gut's involvement in sepsis? | Increased permeability may allow gut flora into the portal vein; edema and ischemia lead to loss of villi and poor absorption; mediators released by the gut hit the liver, then the lung |
| What is the kidney's involvement in sepsis? | Acute renal failure; pyelonephritis is a frequently underlying cause of sepsis; mortality of sepsis and acute renal failure is very high |
| What is the herat's involvement in sepsis? | Tissue edema, microvascular thrombosis, decreased contractility, decreased compliance |
| What is the liver's involvement in sepsis? | Diminished synthetic function, diminished clearance of systemically generated lactate, injured Kupffer cells contribute to general pro-inflammatory state, decreased clearance of occasional microorganisms from the portal circulation |
| Pulmonary edema leads to... | VQ mismatch and hypoxia |
| Decreased cardiac contractility leads to... | diminished cardiac output |
| Peripheral vasodilation leads to... | hypovolemia and diminished cardiac output |
| Peripheral vasodilation leads to... | hypovolemia and diminished cardiac output |
| Hypermetabolic state in the periphery causes... | reduction in venous pO2 and content, stressing the ability of remaining functioning lung to oxygenate blood |
| Reasons oxygen consumption iis abnormal | tissue edema increases the diffusion path from capillaries to mitochondria; local microthrombosis reduces the number of capillaries participating in blood flow to any particular organ; increased levels of nitric oxide directly poisons the inner mitochondrial membrane |
| The mechanisms of sepsis ultimately hinders this... | DO2 (oxygen delivery) |
