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Firstname Lastname, MD PhD!
Title, Department, etc. !
Faculty of Medicine, University of Toronto
“Sepsis and
septic shock”
Alberto Goffi, MD
St. Michael’s Hospital
Toronto, Canada
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Sepsis and septic shock Lecture Slides, Schemes and Mind Maps of Medical Sciences
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Typology: Schemes and Mind Maps
2020/2021
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Main Title Here
Subtitle Goes Here
Firstname Lastname, MD PhD
Title, Department, etc. Faculty of Medicine, University of Toronto
“Sepsis and
septic shock”
Alberto Goffi, MD
St. Michael’s Hospital Toronto, Canada
Disclosures
No conflicts of interest
Disclosures
68 y.o. woman
Two-day history of chills, high fever, cough and shortness of breath.
PMH T2DM; HTN; COPD
Admission to ED Patient appears ill, is coughing, restless and sleepy, but rousable.
BP 70/40 mmHg HR 120/min (regular) RR 34/min T 40.2 °C
ABG: 7.21/25/55/ Lactate: 4.3 mmol/L
Two not uncommon cases...
Sepsis?
- Sepsis is a syndrome shaped by pathogen factors and host factors
with characteristics that evolve over time.
- What differentiates sepsis from infection is an aberrant or
dysregulated host response and the presence of organ dysfunction.
KEY CONCEPTS OF SEPSIS
PATHOGEN FACTORS HOST FACTORS (sex, race and other genetic determinants, age, comorbidities, environment)
Neurologic
Respiratory
Hepatic/GI
Renal
Coagulation
Cardiovascular
- Kaukonen K.M., NEJM
- Vincent J.L, Lancet Respir Med
- Vincent J.L., ICM
- Singer M., JAMA
SEPSIS
SEVERE SEPSIS
SEPTIC SHOCK
SOFA score 2 points
Hospital mortality ~ 10%
- Persisting hypotension requiring vasopressors to maintain MAP 65mmHg
- (^) Serum lactate level > 2 mmol/L (18mg/dL) despite adequate volume resuscitation.
Hospital mortality is in excess of 40%.
THE IMPORTANCE OF SCREENING
KEY CONCEPTS OF SEPSIS
Sepsis-induced organ dysfunction may be occult; therefore, its presence should be considered in any patient presenting with infection.
Unrecognized infection may be the cause of new-onset organ dysfunction. Any unexplained organ dysfunction should thus raise the possibility of underlying infection.
Vincent J.L, Lancet Respir Med 2016 Singer M., JAMA 2016