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Septic Shock

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by

BINH NGUYEN

on 14 June 2014

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Transcript of Septic Shock

Fluids given directly into a vein (intravenously)  Increase blood pressure
Drugs to treat low blood pressure, infection, or blood clotting
-To increase the blood flow to your vital organs, you may be prescribed:
Inotropic medicines
Vasopressors



Antibiotics
Azithromycin
-Targets ribosomes
Penicillin-Targets cell wall
Breathing machine (mechanical ventilation)
Surgery

Septic Shock
Outline
Overview( What is septic shock?)
Causes
Pathophysiology
Treatment for septic shock
Prevention

Overview of Septic Shock
What is Septic shock?
It is a dangerous condition that results from uncontrolled sepsis, a severe infection that evades the body’s defenses.
1. Infection 

Inflammation
2. Inflammation confined to one area  natural chemicals to be released
3. Inflammatory chemicals spread throughout the blood stream blood clots and leaky vessels  depriving of nutrients and oxygen  cause blood pressure to fall
5. Death or organ failures may result
It is most common and most dangerous in elderly people or those with weakened immune systems
Alternative Names: Bacteremic shock; Endotoxic shock; Septicemic shock; Warm shock

Causes
-Bacteremia or viremia: 70% by Gram-negative bacteria
Conclusion
By: Binh Nguyen
Phirun Khim
Shanice Watts
Vinny Vicente

Treatments
-Septic shock can be fatal, and there are few effective treatments.
-To detect the treatment needed the following will be measured
your blood pressure
how much urine you produce
how much oxygen is in your blood


Pathophysiology
Treatments
Affect many vital processes including: blood pressure, breathing and organ function.
Infection or toxins triggers an inflammatory response
Damaging the endothelium can cause microclots of fibrin, neutrophils, platelets, RBCs
Lead to poor oxygen delivery, nutrients and perfusion thru the body especially your vital organs

Vasodilation-widening of blood vessels causing decreased in intravascular volume
Hypotension
Tachycardia
Decreased organ perfusion
Increased vascular permeability= blood vessel and capillary walls become ‘leaky’

Intravascular volume ‘leaks’ into extravascular space

Accumulation of extra vascular fluid
peripheral oedema
Pulmonary oedemarespiratory failure


Risk factors
Diabetes
Diseases of the genitourinary system, biliary system, or intestinal system
Diseases that weaken the immune system such as AIDS
Indwelling catheters (those that remain in place for extended periods, especially intravenous lines and urinary catheters and plastic and metal stents used for drainage)

Pictures of Sepsis
Cellulitis, an infection of the skin, may lead to sepsis, particularly in elderly people and those with diabetes or other illnesses that alter the immune system.
Pictures of Sepsis
This rash, showing petechia and purpura, may be a sign of bacteria in the bloodstream (bacteremia).
Prevention
- The risk of sepsis can be reduced in children by following recommended immunization schedules
- Hospital related infection leading to sepsis can be decreased by strictly following hand washing and hygiene protocols.
- Providing antibacterial drugs in the first few hours is critical

-Gram-negative bacteria: Have a specific kind of cell wall
-The outer membrane contains lipopolysaccaride, which acts as an endotoxin,
-Endotoxins are a serious cause of septic shock
Stop Sepsis Save Lives!
Septic Shock
In order to make diagnosis, the SIRS (systemic inflammatory response syndrome) must first be diagnosed:
-
Tachypnea
(high respiratory rate) > 20 breaths per minute signifying hyperventilation.
-
White blood cell
count either significantly low,
-
Heart rate
> 90 beats per minute
-
Temperature
: Fever or hypothermia


References
http://cid.oxfordjournals.org/content/41/Supplement_7/S490.ful
http://www.intechopen.com/books/severe-sepsis-and-septic-shock-understanding-a-serious-killer/epidemiology-of-severe-sepsis-and-septic-shock
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3488423/
http://www.nlm.nih.gov/medlineplus/ency/article/000668.htm
http://answers.webmd.com/answers/1198388/what-is-septic-shock
http://www.wisegeek.org/what-is-septic-shock.htm
http://en.wikipedia.org/wiki/Septic_shock#Causes
http://www.emedicinehealth.com/sepsis_blood_infection/page10_em.htm#sepsis_prevention
http://www.nlm.nih.gov/medlineplus/ency/article/000668.htm
http://en.wikipedia.org/wiki/Septic_shock
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001689/
http://www.medpagetoday.com/MeetingCoverage/ATS/39339
-
lipopolysaccharides
(LPS) consisting of a toxic fatty acid (
lipid A
) & a complex polysaccharide coat (including
O antigen
)
Free LPS
circulating LPS-binding protein
specific receptor (CD14) on monocytes, macrophages, and neutrophils
potent effector cytokines such as IL-1 and TNF-αalpha
systemic vasodilation, widespread endothelial injury
systemic leukocyte adhesion, diffuse alveolar capillary
High level
damage in coagulation system
disseminated intravascular coagulation (DIC)
multiorgan system failure that affects the liver, kidneys, and central nervous system
Full transcript