SEPSIS - Sepsis: A Complex Disease Begins with an infection...

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Sepsis: A Complex Disease Begins with an infection Some individuals suffering from the condition face a severe systemic inflammatory syndrome Sepsis to septic shock is a continuum Sepsis is an infection with SIRS Severe Sepsis is sepsis with organ dysfunction Not making urine, not thinking clearly, not able to perfuse tissues (capillary refill). .. Septic shock is when we have complete cardiovascular collapse. Intravenous medications (vasopressors) must be taken to support tissue perfusion and blood pressure. The challenge is recognition There are no known rapid diagnostic tools for sepsis. Intuition is needed to determine whether a patient has sepsis Unfortunately, Sepsis is a common disease in the ICU! More than 30% of the patients in ICU at a time deal with the disease. This is unfortunate since the disease is difficult to diagnose. Patients may not be diagnosed and may die as a result of this. The ICU is also very busy. Therefore, not too much time can be allocated to a patient before making a diagnosis. Possible infections leading to Sepsis Purpura Fulminas : A purple rash (often misdiagnosed for an allergic reaction). Caused by bacteria such as strep. This symptom indicates a severe microvascular coagulation!
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Since the blood vessels will coagulate, the perfusion to these tissues is completely halted. Necrotizing Faciitis: Can start as a small red area with lots of pain. The toxins causing this symptom are produced by bacteria such as Streptococci and degrade tissue. Air pockets can be seen in CT scan as a result of tissue degradation. Breast Abscess, Appendicitis, Pneumonia (Bacterial pneumonia) Why worry? 60% mortality rate with septic shock. Only 2% mortality rate with unstable angina Timing, Treatment Strategies, and Recognition are essential influencers to this mortality rate. The incidence rate, mortality rate and hospitalization rate of sepsis is continuously increasing (3/1000 population) In younger individuals the morality rate is higher when there is a pre-existing health problem (Diabetes). What is sepsis caused by? More commonly from Gram-positive bacteria and Fungal infections. Fungal infections are increasing over time due to antibiotics use. The infections are thus antibiotic resistant. An example is Candida infection (Demonstrated below on stomach lining).
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Theories of sepsis Cytokine Theory Bacteria releases mediators Mediators attract macrophages and neutrophils Signals elaborate a massive release of cytokines All this takes place in the capillary networks, arterioles, and venules of the microcirculation. In Sepsis, this mechanism to leukocyte recruitment will
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SEPSIS - Sepsis: A Complex Disease Begins with an infection...

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