Sepsis

Sepsis - causes, management, sepsis bundle

1. Sepsis and Septic Shock Dr. Prasenjit Gogoi MBBS, MEM Attending Consultant Apollo Hospital, Guwahati

2. Introduction Sepsis – A life threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock – Sepsis in which underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality.

3. Risk Factors Infection Older adults Pregnant women Children younger than 1 Chronic disease Weak immune systems

4. Causes Any infection – bacterial, viral or fungal. Most common Pneumonia Infection of digestive tract Infection of the urinary system Bloodstream infection

5. Signs and Symptoms

6. Signs and Symptoms Inflammatory High white blood cell count Immature white blood cells in the circulation Elevated plasma C-reactive protein Elevated procalcitonin Hemodynamic Low blood pressure Low central venous or mixed venous oxygen saturation High cardiac index

7. Signs and Symptoms Organ Dysfunction Low oxygen level Low urine output High creatinine in the blood Coagulation abnormalities Absent bowel sounds Low platelet in the blood High bilirubin levels Tissue Perfusion High lactate in the blood Decreased capillary filling

8. Systemic Inflammatory Response Syndrome

9. SEPSIS STEPS

10. Diagnosis Blood tests – drawn from two sites Evidence of infection Clotting problem Abnormal liver or kidney finctions Impaired oxygen availability Electrolyte imbalance

11. Diagnosis Other tests Urine Wound secretions Respiratory secretions Imaging tests X-rays USG CT MRI

12. Treatment Medications Antibiotics IV fluids Vasopressors Supportive care Oxygen Ventilation Dialysis Surgery Removal of source of infection – abscess, infected tissue or gangrene .

13. Surviving Sepsis Campaign Hour 1 Bundle of Care Elements Measure lactate levels. Obtain blood cultures before administering antibiotics. Administer broad-spectrum antibiotics. Begin rapid administration of 30 mL/kg crystalloid for hypotension or lactate level > 4 mmol /L. Apply vasopressors if hypotensive during or after fluid resuscitation to maintain MAP > 65 mm Hg. www.survivingsepsis.org

14. Thank you..!!