Surgery Definition – What is sepsis?
Surgery Definition – What is sepsis?
Sepsis can be categorized as a form of infection which can be confirmed by the present of 2 out 4 signs of systemic inflammatory response syndrome (SIRS). Patient may present with body temperature of less than 36 Celsius or more than 38.3 Celsius. The white cell count should be less than 4 or more than 4 and the heart rate is more than 100 while the respiratory rates is more than 20. In severe case of sepsis patient may present with signs of systemic inflammatory response syndrome mentioned above and with evidence of end organ dysfunction. Septic shock is categorized as the present of systemic inflammatory response syndrome and hypotension which is refractory to any replacement of the fluid.
Sepsis is managed by considering fluid resuscitation with target of mean arterial pressure of more than 65 mmHg, central venous pressure of around 8 – 12 mmHg, urine output of more than 0.5ml/kg/h and central venous saturation of more than 70%. The lactate response should be considered with the ideal amount is less than 2 mmol/l. Inotropes and vasopressor are considered if failure to reach the target value despite fluid resuscitation. Blood culture is considered before administrating broad spectrum antibiotic which later narrow once organism and sensitivities are identified. Ventilation is needed. Glycemic control with blood glucose monitoring of less than 8.3. If on vasopressor consider steroid after short synacthen test. Also consider activated protein C. Patient should be given deep vein thrombosis and stress ulcer prophylaxis. Avoid any neuromuscular blockers and consider renal replacement therapy.
Sepsis can be categorized as a form of infection which can be confirmed by the present of 2 out 4 signs of systemic inflammatory response syndrome (SIRS). Patient may present with body temperature of less than 36 Celsius or more than 38.3 Celsius. The white cell count should be less than 4 or more than 4 and the heart rate is more than 100 while the respiratory rates is more than 20. In severe case of sepsis patient may present with signs of systemic inflammatory response syndrome mentioned above and with evidence of end organ dysfunction. Septic shock is categorized as the present of systemic inflammatory response syndrome and hypotension which is refractory to any replacement of the fluid.
Sepsis is managed by considering fluid resuscitation with target of mean arterial pressure of more than 65 mmHg, central venous pressure of around 8 – 12 mmHg, urine output of more than 0.5ml/kg/h and central venous saturation of more than 70%. The lactate response should be considered with the ideal amount is less than 2 mmol/l. Inotropes and vasopressor are considered if failure to reach the target value despite fluid resuscitation. Blood culture is considered before administrating broad spectrum antibiotic which later narrow once organism and sensitivities are identified. Ventilation is needed. Glycemic control with blood glucose monitoring of less than 8.3. If on vasopressor consider steroid after short synacthen test. Also consider activated protein C. Patient should be given deep vein thrombosis and stress ulcer prophylaxis. Avoid any neuromuscular blockers and consider renal replacement therapy.
