Ebook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2
Ebook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2
SECTION IVCOMMON CRITICAL ILLNESSES AND SYNDROMESCHAPTER 28SEVERE SEPSIS AND SEPTIC SHOCKRobert s. MunfordDEFINITIONS(Sec Table 28-1) Animals mount bo Ebook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2oth local and systemic responses to microbes that traverse their epithelial barriers and enter underlying tissues. Fever or hypothermia, leukocytosis or leukopenia, tachypnea, and tachycardia are the cardinal signs of the systemic response, that is often called the syĩtetnừ inflammatory response syn Ebook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2drome (SIRS). SIRS may have an infectious or a noninfectious etiology. If infection is suspected or proven, a patient with SIRS is said to have sepsisEbook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2
. When sepsis IS associates! with dysfunction of organs distant from the site of infection. the patient has severe sepsis. Severe sepsis may be accompSECTION IVCOMMON CRITICAL ILLNESSES AND SYNDROMESCHAPTER 28SEVERE SEPSIS AND SEPTIC SHOCKRobert s. MunfordDEFINITIONS(Sec Table 28-1) Animals mount bo Ebook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2itions were developed by consensus conference committees in 1992 and 2001 and have been widely used: there is evidence that the different stages may form a continuum.ETIOLOGYSepsis can be a response to any class of microorganism. Microbial invasion of the bloodstream IS not essential, since local in Ebook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2flammation can also elicit distant organ dysfunction and hypotension, hl fact, blood cultures yield bacteria or fungi in only -20-40% of cases of seveEbook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2
re sepsis and 40-70% of cases of septic shock. Individual gram-negative or gram-positive bacteria account for -70% of these isolates; the remainder arSECTION IVCOMMON CRITICAL ILLNESSES AND SYNDROMESCHAPTER 28SEVERE SEPSIS AND SEPTIC SHOCKRobert s. MunfordDEFINITIONS(Sec Table 28-1) Animals mount bo Ebook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2e or microscopic examination of infected material from a local site; specific identification of microbial DNA or RNA in blood or tissue samples is also used, in some case series, a majority of patients with a clinical picture of severe sepsis or septic shock have had negative microbiologic data.EPID Ebook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2EMIOLOGYSevere sepsis is a contributing factor in >200,0(X) deaths per year in the United States. The incidence of severe sepsis and septic shock hasEbook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2
increased over the past 30 years, and the annual number of cases is now >700,000 (-3 per 1000 population). Approximately two-thirds of the cases occurSECTION IVCOMMON CRITICAL ILLNESSES AND SYNDROMESCHAPTER 28SEVERE SEPSIS AND SEPTIC SHOCKRobert s. MunfordDEFINITIONS(Sec Table 28-1) Animals mount bo Ebook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2ng incidence of severe sepsis in the United States IS attributable to the aging of the population, the increasing longevity of patients with chronic diseases, and the relatively high frequency with which sepsis develops in patients with AIDS. The widespread use of immunosuppressive drugs. indwelling Ebook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2 catheters, and mechanical devices also plays a role.Invasive bacterial infections are prominent causes of death around the world, particular!)' amongEbook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2
young children. In sub-Saharan Africa, for example,careful screening for positive blood cultures found that community-acquired bacteremia accounted fSECTION IVCOMMON CRITICAL ILLNESSES AND SYNDROMESCHAPTER 28SEVERE SEPSIS AND SEPTIC SHOCKRobert s. MunfordDEFINITIONS(Sec Table 28-1) Animals mount bo Ebook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2scherichia coll were the most commonly isolated bacteria. Bactcremic children often had HIV infection or were severely malnourished.PATHOPHYSIOLOGYMost cases of severe sepsis are triggered by bacteria or fungi that do not ordinarily cause systemic disease in immunocompetent hosts (Table 28-2). To su Ebook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2rvive within the human body, these microbes often exploit deficiencies in host defenses, indwelling catheters or other foreign matter, or obstructed fEbook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2
luid drainage conduits. Microbial pathogens, in contrast, can circumvent innate defenses because they (I) lack molecules that can be recognized by hosSECTION IVCOMMON CRITICAL ILLNESSES AND SYNDROMESCHAPTER 28SEVERE SEPSIS AND SEPTIC SHOCKRobert s. MunfordDEFINITIONS(Sec Table 28-1) Animals mount bo Ebook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2C PATIENTSBacteremiaSepticemiaSystemic Inflammatory responsesyndrome (SIRS)SepsisSevere sepsis (similar to "sepsis syn drome")Septic shockRefractory septic shockMultiple-organ dysfunction syndrome (MODS)Predisposition-infection-response-organ dysfunction (PIRO)Critical illness-related corticosteroid Ebook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2 insufficiency (CIRCI)Presence of bacteria in Wood, as evidenced by positive blood cultures Presence of microbes or their toxins in bloodTwo or more oEbook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2
f the following conditions: (1) fever (oral temperature >38:C) or hypothermia (<36'C); (2) tachypnea (>24 breaths/min); (3) tachycardia (heart rate >9SECTION IVCOMMON CRITICAL ILLNESSES AND SYNDROMESCHAPTER 28SEVERE SEPSIS AND SEPTIC SHOCKRobert s. MunfordDEFINITIONS(Sec Table 28-1) Animals mount bo Ebook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2ed microbial etiologySepsis with one or more signs of organ dysfunction—for example:1Cardiovascular: Arterial systolic blood pressure £90 mmHg or mean arterial pressure <70 mmHg that responds to administration of intravenous fluid2Renal: Urine output <0.5 mưkg per hour for 1 h despite adequate fluid Ebook Harrison''s pulmonary and critical care medicine (2nd edition): Part 2 resuscitationSECTION IVCOMMON CRITICAL ILLNESSES AND SYNDROMESCHAPTER 28SEVERE SEPSIS AND SEPTIC SHOCKRobert s. MunfordDEFINITIONS(Sec Table 28-1) Animals mount boSECTION IVCOMMON CRITICAL ILLNESSES AND SYNDROMESCHAPTER 28SEVERE SEPSIS AND SEPTIC SHOCKRobert s. MunfordDEFINITIONS(Sec Table 28-1) Animals mount boGọi ngay
Chat zalo
Facebook