Sepsis 2016(1).ppsx

Hilda Cristina Rodriguez MD Emergenciologa

Causas de SIRS

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

Vincent JL, Moreno R, Takala J, et al; Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. The SOFA (Sepsisrelated Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med. 1996;22(7):707-710.

SEPSIS

(Glasgow Coma Score of 13 or less)

SEPSIS Ileus (absent bowel sounds)

SHOCK SEPTICO

Patients with septic shock can be clinically identified by a vasopressor requirement to maintain a mean arterial pressure of 65 mm Hg or greater and serum lactate level greater than 2 mmol/L (>18 mg/dL) in the absence of hypovolemia.

The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) JAMA. 2016;315(8):801-810.

DIAGNOSTICO Determinar la fuente • Hemocultivos • Orina • LCR • Heridas • Secreciones pulmonares • Imágenes

BACTEREMIA • Presence of viable bacteria (fungi) in the blood, as evidenced by positive blood cultures. • Positive cultures are not obligatory in the diagnosis of sepsis. • Only 17 to 27% of patients with sepsis, and 69% of patients with septic shock actually had positive blood cultures. • More than 30% of patients with sepsis do not have a definite microbiologic diagnosis.

TRATAMIENTO

TERAPIA HÍDRICA

METAS 6 PRIMERAS HORAS

VASOPRESORES

INOTROPICOS

TRANSFUSIONES

PLAQUETAS

CORTICOIDES

Control de la glucosa

Profilaxis

Profilaxis

Terapia renal