Sepsis and Septic Shock Quiz

Sepsis Definition and Recognition

• Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection.
• The criteria used to recognize sepsis include:
• Respiratory rate > 22 breaths/min
• White blood cell count > 12,000 cells/μL or < 4,000 cells/μL
• Serum lactate level > 2 mmol/L
• Blood pressure < 100 mmHg
• Urine output < 0.5 mL/kg/h
• Temperature > 38°C or < 36°C
• Heart rate > 90 beats/min

Anatomical Sources of Sepsis

• The three most common anatomical sources of sepsis are:
• Lungs (pneumonia)
• Abdomen (peritonitis, pancreatitis, cholecystitis)
• Urinary tract (pyelonephritis)

Septic Shock

• Septic shock is a subset of sepsis characterized by:
• Hypotension (systolic blood pressure < 65 mmHg) that requires vasopressors to maintain
• Lactate level > 2 mmol/L
• Septic shock is diagnosed when there is a need for vasopressors to maintain a mean arterial pressure ≥ 65 mmHg.

Sepsis Bundle

• The 'sepsis bundle' includes parameters such as:
• Blood cultures before antibiotics
• Broad-spectrum antibiotics within 1 hour
• Fluid resuscitation with 30 mL/kg of crystalloids
• Vasopressors to maintain mean arterial pressure ≥ 65 mmHg
• Lactate measurement
• Urine output and cardiovascular monitoring

Pathophysiology of DIC

• Disseminated intravascular coagulation (DIC) in sepsis is characterized by:
• Activation of coagulation cascade
• Thrombin generation
• Formation of microthrombi
• Consumption of coagulation factors
• Fibrinolysis inhibition

Treatment of Sepsis

• Norepinephrine is commonly used in septic shock to improve hemodynamics.
• Adjunctive pharmacotherapeutic agents in sepsis treatment aim to:
• Modulate the immune response
• Improve cardiovascular function
• Enhance antimicrobial activity