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Sepsis (Pathophysiology (Pathogens invade tissue and cause damage.…
Sepsis
Pathophysiology
Pathogens invade tissue and cause damage.
Infammatory response is initiated by the body.
Pathogens proliferate and release endotoxins. This may result in bacteremia.
This causes an increased inflammatory response, causing secondary immunosupression.
Endotoxins cause complement and clotting cascade activation, increasing capillary permeability and increased clotting where inflammation is present, decreasing tissue perfusion and intravascular volume.
The cascade of effects from the release of endotoxins, increased inflammatory state, and decreased perfusion causes the classic symptoms present with sepsis.
Clinical Presentation
-confusion/ disorientation
-tachycardia
-tachypnea
-shortness of breath
-pain
-fever, shivering, feeling cold
-clammy/sweaty skin
-hypotension
-multi-system organ failure
-increased white blood cell count
-elevated lactic acid
-decreased urine output
Treatment
Once sepsis is suspected IV fluid bolus and vasopressors are given for low blood pressure, oxygen is administered if indicated for tachypnea and shortness of air, broad spectrum IV antibiotics are administered within 2 hours of suspected sepsis.
Identifiable causes are confirmed with lab and urinalysis results, chest x-rays, and CT scans.
Once the cause is identified with lab results and radiology reports, antibiotics and treatments are centered around treating the cause and supportive care.
Diagnosis
-Thorough physical assessment including signs and symptoms of sepsis present
CBC with elevated wbc count
elevated serum lactic acid
positive blood culture with sensitivity
positive source of infection (pneumonia, urinary tract infection, cellulitis, wound infection, ect)
Epidemiology
-1.7 million American develop sepsis every year
-270,000 Americans die of sepsis every year
-1 of every 3 hospital deaths are attributed to sepsis
Risk Factors
Young children, elderly adults, and immunocompromised patients are those who are more likely to develop sepsis. This includes patients with HIV/AIDS, cancer, diabetes, recent surgeries, liver disease, or other medical conditions.