A | B |
Reason that identification of cases is not reliable... | entry points are busier with long wait times; early findings are hard to distinguish from a lot of other problems; in the elderly, the findings can be very subtle and masked by underlying illness, screening methods suffer from low specificity |
Lab criteria for sepsis... | WBC (<4 or >12); specific organ function tests (liver enzymes, renal function, etc.); coagulation abnormalities (PT, PTT, fibrinogen, D-dimer, etc.) |
What does lactic acid show? | It's a marker of anaerobic metabolism found in sepsis |
Measures to correct hypoperfusion... | Volume resuscitation, packed red cells, pressors and inotropes |
These are ways to monitor the success of early resuscitation... | Arterial blood pressure (A-line), central venous pressure, urine output, arterial oxygen saturation, serial lactate measurements |
IVF of choice for fluid resuscitation... | Normal saline (LR typically a surgical intervention) |
Common problem that develops due to the amount of fluid resuscitation needed... | pulmonary edema |
Probable need for this if pulmonary edema occurs... | mechanical ventilation |
Volume of fluid resuscitation is typically based on this... | CVP measurements |
For correction of abnormal DO2, many published guidelines suggest keeping Hct at this level... | >30% |
Use these if fluid resuscitation does not correct hypotension... | vasopressors and inotropes |
Goal of hemoglobin saturation for respiratory support... | As close to 100% as possible |
25-30% of the patients metabolid demands commonly arise from this... | work of breathing (mechanical ventilation can relieve this) |
The only agent that's been shown to be of clear benefit in sepsis... | Activated protein C (expensive - $8000 per patient) |