Sepsis

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Sepsis

• Incidence, Pathophysiology, Diagnosis, and
  Treatment
• R. Benjamin Smith
• University of Tennessee Health Science Center
• College of Medicine Class of 2007

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Goals and Objectives

• epidemiology
• pathophysiology
• signs and symptoms
• diagnosis
• treatment
• follow up

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What is sepsis?
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Epidemiology

• Incidence
• Morbidity and Mortality
• Race
• Sex
• Age

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Pathophysiology

• Inflammatory cascade
• Course
• Definitions
• -SIRS
• -sepsis
• -severe sepsis
• -septic shock

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Pathophysiology

• Inflammatory cascade
• Course
• Definitions
• -SIRS
• -sepsis
• -severe sepsis
• -septic shock

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Clinical Picture

• Signs and Symptoms
• History
• Physical
• Diagnosis

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Diagnosis

• Labs
• Miscellany

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Treatment

• Pharmacologic
• -antibiotics
• -vasopressors
• -corticosteroids
• -insulin/glucose
• Fluid management
• -renal replacement
• Ventilation

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Treatment contd

• Sedation
• Analgesia and neuromuscular blockade
• Deep-vein thrombosis prophylaxis
• Stress ulcer prophylaxis
• Nutritional support
• ICU

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Follow up

• Prognosis
• Abscesses
• Oral antibiotics

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References

• eMedicine. Systemic Inflammatory Response
  Syndrome. Sept. 29, 2004
• eMedicine. Sepsis, bacterial. Sept. 29, 2004
• 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis
  Definitions Conference. Critical Care Medicine
  2003, Vol. 31, No. 4
• Aird WC. The role of the endothelium in severe
  sepsis and multiple organ dysfunction syndrome.
  Blood. 2003101(10)3765-3777.