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SIRS and MODS

QuestionAnswer
SIRS generalized inflammation in organs remote from initial insult
SIRS criteria must meet 2/4: temperature , 96.8, or > 100.4 respiratory rate > 20 bpm HR > 90 WBC < 4000 or > 12000
MODS failure of two or more organ systems
care for patient with MODS includes: prevent and treat infection maintain tissue oxygenation nutrition and metabolic support appropriate support of individual failing organs
SEPSIS S= shivering, fever E= extreme pain P= pale S=sleepy, difficult to arouse, confused I= I feel like I am going to die S= SOB
consequences of inflammatory response release of mediators direct damage to endothelium hypermetabolism increase in vascular permeability activation of coagulation cascase
organ and metabolic dysfunction hypotension decreased perfusion formation of microemboli redistribution or shunting of blood
respiratory system assessment with MODS alveolar edema, decrease in surfactant, increase in shunt, V/Q mismatch --> ARDS
cardiovascular system assessment with MODS myocardial depression and massive vasodilation results in decreased BP albumin and fluid move out of blood vessels
renal system assessment with MODS AKI, hypoperfusion, release of mediators, activation of RAAS
hypermetabolic state hyper-hypoglycemia insulin resistance catabolic state liver dysfunction lactic acidosis
maintain tissue oxygenation decrease O2 demand and increase O2 delivery sedation, analgesia, rest
ARDS care aggressive O2 therapy and mechanical ventilation
DIC care blood products
renal failure CRRT or dialysis
Created by: ebrewer12
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