Question | Answer |
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 |