Sepsis
• Sepsis "hidden killer"
▪ Infection->immune overreacts->multi-organ failure->death
▪ Exaggerated/overwhelming immune response, huge chem mediator release (more
damage than good)
▪ Siris->sepsis->severe sepsis->septic shock
▪ Septic shock mortality 24-41%
▪ Despite no new antibiotics & resistance, how have patient outcomes been improved?
Bacteraemia: bacteria in blood
Septicaemia:
Septic shock:
Shock:
Why is the death rate high?
• Dismissed as flu
• Rapid development cascade
• Symptoms present too late
• Poorer countries access to healthcare
• Antimicrobial resistance
• HAI
• AWARENESS
What is being done?
• Importance of recording p.vitals
• Screening checklists
• NHS Action Plans
• Spot the signs campaigns:
Aims: early detection->improved patient outcomes
• identification, diagnosis & management
• Improve survival & decrease long-term disability
, Aeitology:
▪ Frequency: respiratory rtact>UTI>soft-tissue
▪
Cell-wall component Examples Immune response Mehanism of injury
LPS g-ve
Petidoglycan g+ve & -ve
Lipoteichoic acid g+ve
Mehanisms of injury-->organ failure
▪ Hypoxic hypoxia
▪ Direct cytotoxicity-->histocytic anoxia
▪ Coagulopathy
▪ immunosuppression
▪ Apoptosis
Individual patient factors effects the risks, example:
Cardiovasc dysfunction:
▪ Derangement in autoreg of circulatory system
▪ Systemic vasodilation
▪ Hypotension
▪
S shiver,fever, extreme cold
E extreme pain
P pale/discoloured skin
S sleepy & hard to wake
I "I feel like I am going to die"
S short of breath
• Sepsis "hidden killer"
▪ Infection->immune overreacts->multi-organ failure->death
▪ Exaggerated/overwhelming immune response, huge chem mediator release (more
damage than good)
▪ Siris->sepsis->severe sepsis->septic shock
▪ Septic shock mortality 24-41%
▪ Despite no new antibiotics & resistance, how have patient outcomes been improved?
Bacteraemia: bacteria in blood
Septicaemia:
Septic shock:
Shock:
Why is the death rate high?
• Dismissed as flu
• Rapid development cascade
• Symptoms present too late
• Poorer countries access to healthcare
• Antimicrobial resistance
• HAI
• AWARENESS
What is being done?
• Importance of recording p.vitals
• Screening checklists
• NHS Action Plans
• Spot the signs campaigns:
Aims: early detection->improved patient outcomes
• identification, diagnosis & management
• Improve survival & decrease long-term disability
, Aeitology:
▪ Frequency: respiratory rtact>UTI>soft-tissue
▪
Cell-wall component Examples Immune response Mehanism of injury
LPS g-ve
Petidoglycan g+ve & -ve
Lipoteichoic acid g+ve
Mehanisms of injury-->organ failure
▪ Hypoxic hypoxia
▪ Direct cytotoxicity-->histocytic anoxia
▪ Coagulopathy
▪ immunosuppression
▪ Apoptosis
Individual patient factors effects the risks, example:
Cardiovasc dysfunction:
▪ Derangement in autoreg of circulatory system
▪ Systemic vasodilation
▪ Hypotension
▪
S shiver,fever, extreme cold
E extreme pain
P pale/discoloured skin
S sleepy & hard to wake
I "I feel like I am going to die"
S short of breath
