Sepsis resident survival guide

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Definition

• Sepsis = Infection + SIRS

• The presence of systemic inflammatory syndrome (SIRS) is due to many factors. The presence of infection increases the chances of sepsis and increase the SIRS criteria .

• The endothelial dysfunction is the main trigger transforming the localized infection into systemic organ dysfunction

• There is no definitive biomarkers have been associated with the endothelial dysfunction of sepsis.

With sepsis, at least 1 of the following is typically included: [HOME]

• Hypoxemia (arterial oxygen tension [PaO2] < 72 mm Hg at fraction of inspired oxygen [FiO2] 0.21; overt pulmonary disease not the direct cause of hypoxemia)
• Oliguria (urine output < 30 mL or 0.5 mL/kg for at least 1 h)
• Mental status alteration
• Elevated plasma lactate level > 4mg

Multiple organ dysfunction syndrome (MODS) is the presence of altered organ function in a acutely ill patient whom homeostasis cannot be maintained without intervention.

Management

Aggressive therapy with hemodynamic monitoring