Pathology - University of Arizona



Pathology

Lecture 8 Sepsis and Related Concepts

1) Define and use intelligently in a sentence the terms, SIRS, sepsis, severe sepsis, septic shock, MODS.

SIRS – Systemic inflammatory response syndrome (SIRS) has 2 of the following: high or low temp, leukocytosis (WBC >11,000), tachypnea, or tachycardia.

Sepsis – SIRS plus infection (e.g. pneumonia, cystitis, and cholecystitis).

Severe sepsis – sepsis with organ dysfunction (e.g. renal failure, coma, etc.)

Septic shock – severe sepsis causing shock, i.e. hypotension with organ hypoperfusion, peripheral pooling of blood, etc.

MODS – Multiple Organ Dysfunction Syndrome (MODS) and Multiple Organ Failure (MOF) are terms used to describe severe sepsis.

2) List some vital organs affected by sepsis. Brain, lungs, heart, gut, kidneys, liver, pancreas, adrenals, skeletal muscle, and skin.

3) Give the health impact of sepsis in terms of morbidity and mortality, incidence, and effectiveness of therapy.

|Morbidity – Mortality – Incidence |Effectiveness of therapy |

|751,000 US cases/year |Therapies against the mediators, toxins, and cytokines (including |

|30% ~215,000 deaths |corticosteroids, endotoxin neutralizing agents, TNF-α inhibitors, interleukin |

|3/1000 adults/year |receptor antagonists, etc.) have been unsuccessful. Activated protein C and |

|10th leading cause of death |supportive measures (antibiotics, organ support, stabilize glucose levels, and|

|2/100 hospital admissions |maintain BP) have proven effective. |

4) Describe the hematologic disorder that usually accompanies sepsis. Severe sepsis is nearly always accompanied by disorders of coagulation, including microthrombi of end organs (dissiminated intravascular coagulation) which leads to decreased perfusion, hypoxia, and necrosis of tissue. Tissue factor is released activating the extrinsic clotting pathway. Hemorrhage may also result.

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