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Septic Issues

Sepsis, Sepsis Syndrome, and Septic Shock

Big thing with septic shock ? * number one cause of ICU deaths
Process of Septic Shock ? (already in last lec.) * Bacterial infection --> Bacteremia --> Host inflammatory response --> Increased Inflammation & Coagulation/Decreased Fibrinolysis --> Changes in endothelium, microvasculature, BP --> Shock & Organ failure
Know the Septic definitions from the Bd Culture Lec. .
community-acquired pneumonia cause ? * Encapsulated pyrogens (strep pneumo)
Most common UTI cause ? * Gram negative rods (E.Coli)
Severe burns usually cause ? * Anaerobes (like Pseudomonas)
Special consideration for Pseudomonas ? * Gram negative bacilli -- Ubiquitous; opportunistic pathogen -- Oxidase + Pigments and toxins ........... * can see in immuncompromised and Neutropenic patients ...... * it has a HIGHER mortality rate is sepsis
Good Pseudomonas indicator ? * Ecthyma gangrenosum lesion ....* looks like a black lesion on the skin
Main reason why we get septic shock ? * results from an overwhelming host mediator response that induces pathologic changes
Some host factors that contribute to sepsis ? * Kinins - PAF - TNF-a - NO - TLR - PGs _ Complement - ILs
The coagulation abnormalities seen in sepsis ? * Get an increase in Coag/Inflam factors and a decrease in fibrinolysis
Signs and Symptoms Suggesting Sepsis Syndrome ? * A patient may feel apprehensive but appear normal, except for slight tachypnea and tachycardia. ...Developing sepsis?
Hemo and CV aspects of Sepsis ? * get leaky vessels due to VD --> SVR .... * HypoTN responsive to refractory fluid retention..... * Get CV insuff. and hypoperfusion.... * Coag issues to that lead to organ damage
Patient Management ? * Shock and Organ Failure - fluids given and normalize CV ...... * Antimicrobial TmT..... * Invasive Procedures to remove the infection/abscess.... * Put Patient in ICU
The most important considerations in patient management ? * Prevention.... Limit the possibilities of a bacteria exposure
Created by: thamrick800