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Chapter 23
Critical Care Sepsis
12
Nutrition
Professional
08/02/2016

Additional Nutrition Flashcards

 


 

Cards

Term
What is the difference between SIRS, sepsis, and septic shock?
Definition

SIRS is a constellation of symptoms including elevated heart rate, temperature, respiratory rate, and WBC count.

 

Sepsis = SIRS + infection

 

Septic shock = sepsis + hemodynamic instability

 

Term
What factors can cause SIRS?
Definition

SIRS can be caused by infection (sepsis) or by non-infection etiology such as trauma, pancreatitis, hemorrhage, ischemia, burn injury, etc.

 

 

Term
What type of inflammatory response is seen in patients with sepsis?
Definition
Patients with sepsis exhibit both an inflammatory and anti-inflammatory response
Term
What is the standard medical treatment for sepsis?
Definition
Administration of antimicrobial agents and removal of the infectious source
Term
Have efforts to reverse sepsis been successful? How does this affect nutrition intervention?
Definition
No, not at all. Current nutritional therapy focuses on support of patients DURING sepsis rather than trying to stop it.
Term
How does sepsis affect carbohydrate metabolism?
Definition
Hyperglycemia and insulin resistance are uniformly found in sepsis
Term
How does sepsis affect gluconeogenesis?
Definition
Moderate or severe infection is associated with at 150% to 200% increase in glucose production
Term
What are the mechanisms for hyperglycemia 2/2 sepsis?
Definition
  • Increased gluconeogenesis
  • Decreased glucose uptake
  • Insulin resistance
Term
How does sepsis affect protein metabolism?
Definition
Protein breakdown and synthesis are both accelerated during sepsis, but patients generally remain in net negative nitrogen balance
Term
How does sepsis affect lipid metabolism?
Definition
It causes lipolysis, which can often induce hypertriglyceridemia
Term
How does sepsis affect energy expenditure?
Definition
Sepsis is associated with a significant increase in energy expenditure (20-60% above basal energy expenditure)
Term
What are the advantages of lipids as an energy source in sepsis?
Definition
  1. Lipids are energy-dense which allow for volume-restricted delivery of calories (useful for renal failure or pulm edema)
  2. Respiratory quotient is smaller for lipids than carbohydrates
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