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INFLAMMATORY
RESPONSE SYNDROME
MULTIPLE ORGAN
DYSFUNCTION
SYNDROME
Define SIRS / sepsis / severe sepsis - MODS septic
shock
Delineate difference between sepsis SIRS and MODS
Septic Shock:
Definition: sepsis plus 1 of the following:
decreased peripheral pulses (compared to
central pulses)
capillary refill:
>2 seconds
mottled or cool extremities (cold shock)
flash capillary refill (vasodilated / warm
shock)
decreased urine output (< 1 mL/kg/hr
Definition
progressive reversible dysfunction of 2 organs
from acute disruption of normal homeostasis
requiring intervention
Primary MODS
immediate systemic response to injury or insult
Needs mostly<1 week in ICU, better prognosis,
Secondary MODS
progressive decompensation from host
response & 2nd hits
Needs >1week in ICU, worse prognosis
Infection
Inflammatory Endothelial
Vasodilation
Mediators Dysfunction
Ischemia
Cell Death
Organ Dysfunction
Since the ability of the body to provide oxygen and nutrients is
interrupted, the heart compensates by pumping faster ( HR)
HYPOTENSION occurs because of vasodilation.
To compensate for the decreased oxygen concentration, the
patient tends to breathe faster, and also to eliminate more
carbon dioxide from the body.
( RR) or ( PaO2)
The inflammatory response is activated because of the invasion
of pathogens.
Decreased urine output. The body conserves water to avoid
undergoing dehydration because of the inflammatory process.
Decreased peristalsis
Decreased integrity of
the gut lining Colonization of
normal GI flora up
Translocation of normal into the orpharynx
GI bacteria into systemic
circulation
Aspiration of bacteria
and initiation of a
Systemic infection inflammatory response
and SIRS in the lung
Hypoperfusion Ischemia of the liver and gallbladder