SEPSIS
Rajat Pareek, MD
Pediatric SIRS
Non specific inflammatory changes
occuring after trauma, infection,
burns, pancreatitis and other
diseases.
Definition of SIRS
Atleast 2 /4 cirteria, one of which MUST be
abnormal Temp/abnormal leucocyte count
1. Core temp >38.5, 2SD above normal for age in
absence of external stimulus, chr drugs, painful
stimuli/ unexplained persistent elevation over a ½-
4hr time frame OR children 10%
immature neutrophils.
Definition of INFECTION
A suspected or proven (by Culture, Tissue
stain, PCR) infection caused by any
pathogen
OR
Clinical syndrome asso with high probablity of
infection.
Evidence of infection: PE findings, imaging,
labs ie CXR, petechial rash, Increased WBCs
in sterile body fluids, etc.
Definition of SEPSIS
SIRS + INFECTION= SEPSIS
Definition of SEVERE SEPSIS
SEPSIS
+
One of the foll:
1. CV organ dysfunction
2. ARDS
3. >=2 more other organ dysfunction
Definition of SEPTIC SHOCK
SEPSIS
+
CV ORGAN DYSFUN
=
SEPTIC SHOCK
Organ Dysfunction
CV Dysfunction:
1. Hypotension 5mcg/kg/min or
dobutamine/epi/norepi at any dose)
OR
3. 2 of the foll:
- Unexplained metabolic acidosis: base deficit >5
- Increased art lactate >2 times upper limit of normal
- Oliguria: UO 5 sec
- Core to peripheral temp gap > 3C
Organ Dysfunction
Respiratory Dysfunction
1. PaO2/FiO2 65 torr or 20 mm Hg over
baseline PaCO2
OR
3.