https://idwiki.org/index.php?action=history&feed=atom&title=Sepsis 2026-05-12T23:36:20Z Revision history for this page on the wiki MediaWiki 1.43.8 https://idwiki.org/index.php?title=Sepsis&diff=5860&oldid=prev 2020-08-12T01:25:15Z

<p>added ddx</p> <a href="https://idwiki.org/index.php?title=Sepsis&amp;diff=5860&amp;oldid=4679">Show changes</a>

Aidan https://idwiki.org/index.php?title=Sepsis&diff=4679&oldid=prev 2020-07-05T20:46:01Z

<p><span class="autocomment">Definition</span></p> <table style="background-color: #fff; color: #202122;" data-mw="interface"> <col class="diff-marker" /> <col class="diff-content" /> <col class="diff-marker" /> <col class="diff-content" /> <tr class="diff-title" lang="en"> <td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td> <td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 20:46, 5 July 2020</td> </tr><tr> <td colspan="2" class="diff-lineno">Line 7:</td> <td colspan="2" class="diff-lineno">Line 7:</td> </tr> <tr> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** Characterized by both '''lactate &amp;gt;2mmol/L and pressors''' to keep MAP ≥65 despite fluids</div></td> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** Characterized by both '''lactate &amp;gt;2mmol/L and pressors''' to keep MAP ≥65 despite fluids</div></td> </tr> <tr> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** Mortality 35-54%</div></td> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** Mortality 35-54%</div></td> </tr> <tr> <td class="diff-marker" data-marker="−"></td> <td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><br /></td> <td colspan="2" class="diff-empty diff-side-added"></td> </tr> <tr> <td class="diff-marker" data-marker="−"></td> <td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div></div></td> <td colspan="2" class="diff-empty diff-side-added"></td> </tr> <tr> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br /></td> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br /></td> </tr> <tr> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Management ==</div></td> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Management ==</div></td> </tr> </table>

Aidan https://idwiki.org/index.php?title=Sepsis&diff=4458&oldid=prev 2020-07-04T01:17:55Z

<p>Imported from text file</p> <p><b>New page</b></p><div>== Definition ==<br /> <br /> * Life-threatening organ dysfunction caused by a dysregulated host response to infection<br /> * Characterized by an acute change in SOFA score ≥ 2 points in the context of infection<br /> ** Mortality 10%<br /> * Septic shock is sepsis with profound underlying circulatory and metabolic derangements<br /> ** Characterized by both &#039;&#039;&#039;lactate &amp;gt;2mmol/L and pressors&#039;&#039;&#039; to keep MAP ≥65 despite fluids<br /> ** Mortality 35-54%<br /> <br /> <br /> <br /> == Management ==<br /> <br /> * Based on the [http://www.survivingsepsis.org/Guidelines/Pages/default.aspx Surviving Sepsis Campaign]<br /> * [http://www.survivingsepsis.org/SiteCollectionDocuments/Surviving-Sepsis-Campaign-Hour-1-Bundle-2018.pdf Hour-1 Bundle]: to be started within 1 hour of triage<br /> ** Measure lactate, repeat within 2-4h if &amp;gt;2mmol/L<br /> ** Obtain blood cultures, before antibiotics if possible<br /> ** Provide broad-spectrum antibiotics<br /> *** Each hour delay increases mortality by 7.6%<br /> *** Inappropriate initial antibiotics double mortality from 30% to 60%<br /> ** Administer 30ml/kg crystalloid for hypotension or lactate ≥4 mmol/L<br /> ** Vasopressors if needed to maintain MAP ≥65 mmHg<br /> *** Norepinephrine then vasopressin<br /> * After the hour-1 bundle<br /> ** Don&#039;t forget to reassess lactate<br /> ** Assess fluid responsiveness and bolus more fluids, if indicated<br /> *** Passive leg raise<br /> *** Pulse pressure variation<br /> *** SV on PoCUS<br /> *** IVC<br /> **** Intubated/ventilated: distensibility index &amp;gt;15-20%<br /> **** Intubated/breathing: cannot use<br /> **** Not intubated: IVC &amp;lt;2cm and variation &amp;gt;50%<br /> ** Add pressors, if needed to maintain MAP ≥65mmHg<br /> *** Norepinephrine first, at a dose of 0.03-3mcg/kg/min<br /> *** Vasopressin or epinephrine second<br /> *** Dobutamine third<br /> ** Add steroids, if indicated<br /> *** No steroids if they have responded to fluids and pressors<br /> *** If still unwell, give hydrocortisone 200mg IV total daily dose<br /> **** Slight improvement in mortality seen in [https://dx.doi.org/10.1056/NEJMoa1705716 one trial]<br /> **** May be beneficial in shock<br /> **** [https://dx.doi.org/10.1136/bmj.k3284 A systematic review from BMJ]<br /> <br /> [[Category:Critical care]]<br /> [[Category:Infectious diseases]]</div>

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