Sepsis & Septic Shock Summary Flashcards

These flashcards cover key definitions, symptoms, treatments, and complications associated with sepsis and septic shock, as discussed in the lecture notes.

What does sepsis induce in terms of blood pressure?

Sepsis-induced hypotension is defined as a systolic BP less than 90 mm Hg or MAP less than 70 mm Hg.

What is the Sepsis-3 definition of sepsis?

Life-threatening organ dysfunction caused by a dysregulated host response to infection.

What is required for septic shock diagnosis according to Sepsis-3?

Persistent hypotension requiring vasopressor support and continued elevated serum lactate after fluid resuscitation.

Which type of infections cause approximately half of sepsis cases?

Pulmonary infections.

What are the most common gram-negative bacteria associated with sepsis?

Escherichia coli, Klebsiella species, Proteus species, Enterobacter species, Pseudomonas aeruginosa.

What is the most common gram-positive bacterium in sepsis?

Staphylococcus aureus.

What is a key characteristic of anaerobic bacterial infections in sepsis?

Polymicrobial infections account for 5% to 39% of sepsis cases.

What fungal organism is most commonly associated with bloodstream infections in sepsis?

Candida albicans.

What is the SOFA scoring system used for?

Evaluating organ dysfunction in septic patients.

How is acute kidney injury defined in the context of sepsis?

An increase in serum creatinine of at least 0.3 mg/dL within 48 hours.

What are the early symptoms of sepsis?

Fever, chills, and change in mental status.

What late symptoms indicate worsening sepsis?

Lactic acidosis, oliguria, hypotension, and decreased organ function.

What treatment is recommended for septic shock concerning glucocorticoids?

Low dose hydrocortisone 200 mg/day for hemodynamically unstable patients.

Why is fluid resuscitation critical during early sepsis management?

It counteracts sepsis-induced hypoperfusion.

What is the recommended amount of crystalloids for initial fluid resuscitation in septic patients?

At least 30 mL/kg within the first 3 hours.

What are the main vasopressors used in septic shock?

Norepinephrine is the first-line agent, with vasopressin and epinephrine as alternatives.

What are the complications associated with sepsis?

Disseminated intra-vascular coagulation (DIC) and acute respiratory distress syndrome (ARDS).

What does the presence of tissue factor in DIC lead to?

Activation of the coagulation cascade and formation of clots.

What characterizes the hemodynamic effects of sepsis?

Low systemic vascular resistance and high cardiac output with tachycardia.

What role does glucose control play in managing septic patients?

Insulin is initiated if blood glucose is greater than 180 mg/dL to avoid hypoglycemia.

What is the empirical treatment approach for community-acquired pneumonia in sepsis?

Ceftriaxone or ciprofloxacin or levofloxacin.

What antibiotic is a drug of choice for MRSA-associated infections?

Vancomycin.

What are the signs of a severe infection in the context of sepsis?

Temperature instability, tachycardia, and altered mental status.

What should be done within 1 hour of diagnosing sepsis?

Initiate empiric combination antibiotic therapy.

What is indicated for VTE prophylaxis in septic patients.

Use of LMWH over unfractionated heparin.