Sepsis

Sepsis

1. Epidemiology

   • 28-60% mortality in the U.S.
   • Number 1 cause of death in non-coronary ICUs

2. Pathophysiology of Alterations

   • Decrease in Tissue Perfusion
   • Cytokine release, Inflammatory Response
   • Impaired tissue perfusion
   • Vasoconstriction and Vasodilation
   • Altered Hematology

3. Risk Factors

   • History of recent infection
   • Surgical Wounds
   • Immunosupression
   • Splenectomy
   • Alcoholism
   • Recent Procedure
   • Indwelling Catheters, Central lines and other implanted devices

4. Clinical Presentation

   • Altered Mental Status
   • Temperature >38 C or < 36 C
   • HR > 90 bpm
   • RR > 20 or PaCO@ < 32 mm Hg
   • WBC >12,000 or < 4,000 or bands >10%
   • Lactate > 2
   • Urine < 0.5mL/Kg
   • Hypotension

5. Diagnosis

   • Positive cultures
   • at least 2 alterations are present
   • Blood tests
   • Chest X-Ray or CT scan
   • History and Physical

6. Treatment

   • Sepsis Resuscitation Bundles
     • Cultures
     • Labs
     • Antibiotics
     • Crystalliods
   • Steroids
   • Blood Glucose Control
   • CVC with CVP measurement