septic shock

소개글

Surviving Sepsis Campaign 2008 을 기초로 한 septic shock 에 대한 내용입니다.
SIRS & sepsis & septic shock & management

목차

1. Definitions
2. Normal physiology
- Immune system
3. Pathophysiology
4. Diagnosis
5. Treatment

본문내용

1. SIRS(systemic inflammatory response syndrome)/Sepsis

Manifested by two or more of the following conditions
* Temperature > 38˚C or < 36 ˚C
* Heart rate > 90 bpm
* Respiratory rate > 20rpm or
* PaCO₂< 32mmHg
* WBC count > 12,000/mm³ or
< 4,000/mm³ or
> 10% immature (band) forms

SEVERE SEPSIS
Acute organ dysfunction secondary to infection
known or suspected infection
Evidence of at least one organ dysfunction
or hypoperfusion abnormalities

SEPTIC SHOCK
Septic shock : hypotension despite fluids + ↓perfusion → MODS

Hypotension not reversed with fluid resuscitation and associated with organ dysfunction
or hypoperfusion abnormalities

Hypotension
SBP < 90mmHg or
↓≥40 from baseline,
without other causes

MODS (Multiple Organ Dysfunction Syndrome )
Progressive distant organ failure (initially uninvolved) following severe infectious or noninfectious insults (severe burn, multiple trauma, shock, acute pancreatitis)

참고 자료

Immunology (third edition)
Harrison’s 내과학 (vol.2)
Internal medicine – 카톨릭의과대학내과학교실
중환자실 표준 운영지침
http://www.survivingsepsis.org
http://en.wikipedia.org
http://www.medscape.com