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

7. Signs and Symptoms

8. 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

9. 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

10. Systemic Inflammatory Response
Syndrome

11. SEPSIS STEPS

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

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

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

15. 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

16. Thank you..!!