Term
| sepsis is the leading cause of death in _ ICUs |
|
Definition
|
|
Term
Risk of death after sepsis increases for
_ years |
|
Definition
|
|
Term
|
Definition
| invasion of organisms in usual sterile site |
|
|
Term
|
Definition
| bacteria in blood, confirmed by culture |
|
|
Term
| how mnay factros to have SIRS |
|
Definition
|
|
Term
| what is defined as sepsis |
|
Definition
|
|
Term
| what is defined as severe sepsis |
|
Definition
| sepsis + organ failure, hypotension (<90) |
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|
Term
| septic shock is defined as |
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Definition
| severe sepsis not alleviated by fluids |
|
|
Term
| what diseases can cause SIRS |
|
Definition
pancreatitis
trauma
burns
ischemia
hemmorhagic |
|
|
Term
what are the common sites of infection
which is the most common? |
|
Definition
resp
UTI
intra abdoiminal
respiratory |
|
|
Term
| what type of pathogen is most common? |
|
Definition
|
|
Term
| what are the major G + orgs |
|
Definition
| S. aureus, step pneumonia, CONS, enterococci |
|
|
Term
| what has septic shock % 50 |
|
Definition
|
|
Term
| what two types of infective organisms have higher mortality |
|
Definition
|
|
Term
| what is the common fungi? |
|
Definition
|
|
Term
|
Definition
pseudomonus
Enterobacter: e coli, klebsiella |
|
|
Term
| what are the proinflammatory cytokines? |
|
Definition
|
|
Term
| what are the antiinflammatory mediators |
|
Definition
|
|
Term
|
Definition
| infection->proimflamm-> 4 diff pathways->shock, organ failure, death |
|
|
Term
| proinflamm mediators go to what 4 pathoways |
|
Definition
ACTHS
porcoag
compliment
leukocyte/endotheial activation |
|
|
Term
| the procoagulation acitvaiton lead to? |
|
Definition
kilikrien kinase activation
vasodilation |
|
|
Term
| what does ACTH release lead to? |
|
Definition
|
|
Term
| what does leukocyte/endotheial activation elad to? |
|
Definition
anti-inflammatory mediators
imblanace of pro vs anti |
|
|
Term
| what does the compliment system lead to? |
|
Definition
PMN activation
endothelial damage and capillary leak |
|
|
Term
clinical presentation of:
CNS |
|
Definition
|
|
Term
clinical presentation of:
CV |
|
Definition
HR increased
BP decreasedd |
|
|
Term
clinical presentation of:
Resp |
|
Definition
|
|
Term
clinical presentation of:
renal |
|
Definition
proteinuria
oliguria
azotemia |
|
|
Term
clinical presentation of:
liver |
|
Definition
increased lfts
increased bilirubin
decreased clotting |
|
|
Term
clinical presentation of:
GI |
|
Definition
|
|
Term
clinical presentation of:
Heme |
|
Definition
increased platelets
increased or decreased WBCs |
|
|
Term
clinical presentation of:
metabolism |
|
Definition
hyperglycemia
hypoglycemia
lactic acidosis |
|
|
Term
| symptoms of primary/early sepsis |
|
Definition
| tachycardia, tachypnea, leukocytosis, hyperglycemia, fever, proteinuria |
|
|
Term
| symptoms of late/ complicated sepsis |
|
Definition
hypotension
hypoglycemia
cytopenia
lactic acdiosis
organ failure
GI bleed |
|
|
Term
| biggest cause of increased mortality |
|
Definition
|
|
Term
| how long can you delay ABX? |
|
Definition
|
|
Term
amt of blood samples?
where is 1 taken from?
if have _ then also taken sample from these |
|
Definition
2
percutaneous
vascualr access devises |
|
|
Term
| Early therapy is used for how long? |
|
Definition
|
|
Term
|
Definition
CVP: 8-12
MAP>65
O2>90 or venous>60
infection control
urin output >.5ml/kg/hr |
|
|
Term
| what is the early goal directed treatments |
|
Definition
|
|
Term
| what is a way to help ABX therapy |
|
Definition
identify the infection source
remove this if possible |
|
|
Term
when do you consider combo therapy?
how long does this therapy last? |
|
Definition
pseudomonas
neutropenic ANC<1500
ONLY 3-5 DAYS |
|
|
Term
| when do you reassess and descalate? |
|
Definition
|
|
Term
what are the hemodynamic management?
who is this for? |
|
Definition
fluid
ppl w/ hypotension or serum lactate >4 |
|
|
Term
| what is the most common fluid given? |
|
Definition
|
|
Term
| what are the cardiovascular mamangemnt |
|
Definition
|
|
Term
| what are the 1st line vasopressors |
|
Definition
|
|
Term
| who do you give vasopressors to? |
|
Definition
|
|
Term
when do you give inotropic agents?
what is the agent? |
|
Definition
cardiac output low
dobutamine |
|
|
Term
if central oxygen not > 90 or venous >60
what are the 3 options |
|
Definition
more fluid
packed red blood cells to meatocrit >30
dobutamine 20 mc/kg/min |
|
|
Term
| when do you use steroids? |
|
Definition
fluida nd vasopressure failure
only in shock |
|
|
Term
| what is the steroid used? |
|
Definition
|
|
Term
| if another steroid besides the rpeferred is used what needs to be added |
|
Definition
| fludrocortisone 50 mcg qd |
|
|
Term
|
Definition
|
|
Term
| when do you give fresh frozen plasma |
|
Definition
planned invasive procedure
bleeding |
|
|
Term
platelet admin:
no risk of bleeding
risk for bleeding
invasive procedure |
|
Definition
5 x10^9
5-10 x 10^9
50 x 10^ 9 |
|
|
Term
| what blood product is never given? |
|
Definition
|
|
Term
| what are the supportive therapies? |
|
Definition
glucose
DVT prophyl
stress ulcer prophylax
nutrition
hemodialysis |
|
|
Term
|
Definition
|
|
Term
| what is given for DVT prophylaxis |
|
Definition
|
|
Term
| what is given fro stress ulcer prophylaxis |
|
Definition
|
|
