Sepsis - Diagnosis and Management

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

SEPTIC SHOCK is a subset of sepsis in which underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality. Patients w/ septic shock are identified with the following 3 features:

 1. Clinical construct of sepsis 

 2. Persistent hypotension (requiring vasopressors to maintain MAP >65 mm Hg)

 3. Serum lactate >2 mmol/L (despite adequate volume resuscitation)

Previously, we used SIRS for screening, which was defined as positive if 2 of the following were present:

 1. Temp > 38 C or < 36 C

 2. HR > 90 bpm

 3. RR > 20 breaths/min

 4. WBC > 12 K or < 4K

We now use qSOFA, defined as positive if 2 of the following are present:

 1. AMS (GCS < 15)

 2. SBP < 100

 3. RR > 22

qSOFA > 2 indicates increased likelihood of prolonged ICU stay or in-hospital mortality



Management Principles: Early recognition and treatment with:

1 Empiric broad spectrum antibiotics

2 Initial fluid resuscitation

3 Vasopressor support (if needed)

4 Source identification and control



Dr. Meredith Greer @EmmGeezee



#Sepsis #Criteria #Diagnosis #Management #QSOFA #SIRS #criticalcare #icu