Skip to Main Content
Home Books Quick Answers: Pharmacy

Sepsis and Septic Shock

  • Sections
  • Print
  • Get Citation

    Citation

    Disclaimer: These citations have been automatically generated based on the information we have and it may not be 100% accurate. Please consult the latest official manual style if you have any questions regarding the format accuracy.

    AMA Citation
    Sepsis and Septic Shock. In: Roller LK, Baumgartner L, Desselle SP. Roller L.K., & Baumgartner L, & Desselle S.P.(Eds.),Eds. Lauren K. Roller, et al.eds. Quick Answers: Pharmacy. McGraw-Hill; Accessed July 09, 2020. https://accesspharmacy.mhmedical.com/content.aspx?bookid=2735&sectionid=228236117
    APA Citation
    Sepsis and septic shock. Roller LK, Baumgartner L, Desselle SP. Roller L.K., & Baumgartner L, & Desselle S.P.(Eds.),Eds. Lauren K. Roller, et al. (2019). Quick Answers: Pharmacy. McGraw-Hill. https://accesspharmacy.mhmedical.com/content.aspx?bookid=2735&sectionid=228236117
    MLA Citation
    "Sepsis and Septic Shock." Quick Answers: Pharmacy Roller LK, Baumgartner L, Desselle SP. Roller L.K., & Baumgartner L, & Desselle S.P.(Eds.),Eds. Lauren K. Roller, et al. McGraw-Hill, 2019, https://accesspharmacy.mhmedical.com/content.aspx?bookid=2735&sectionid=228236117.

    Download citation file:

    RIS (Zotero)
    EndNote
    BibTex
    Medlars
    ProCite
    RefWorks
    Reference Manager
    Mendeley
    © Copyright
  • Tools
  • Search Book
  • Clip
Top

SOURCE

Source: Kang-Birken SL. Sepsis and septic shock. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861&sectionid=133893876. Accessed May 22, 2017.

DEFINITION

  • Systemic inflammatory response syndrome secondary to infection.

  • Definitions of terms related to sepsis in Table 1.

TABLE 1.Definitions Related to Sepsis
View Table|Favorite Table|Download (.pdf)
TABLE 1. Definitions Related to Sepsis
Condition Definition
Bacteremia (fungemia) Presence of viable bacteria (fungi) in the bloodstream
Infection Inflammatory response to invasion of normally sterile host tissue by the microorganisms
Systemic inflammatory response syndrome Systemic inflammatory response to variety of clinical insults that can be infection but also of noninfectious etiology. Response manifested ≥2 of following conditions: temperature >38°C (100.4°F) or <36°C (96.8°F); heart rate >90 beats/min; respiratory rate >20 breaths/min or PaCO2 <32 torr; WBC >12,000 cells/mm3, <4000 cells/mm3, or >10% immature (band) forms.
Sepsis

SIRS secondary to suspected or documented infection.

Additional criteria include general variables (altered mental status, positive fluid balance of >20 mL/kg over 24 hours, hyperglycemia >120 mg/dL [>6.7 mmol/L]); inflammatory variables (plasma C-reactive protein/procalcitonin >2 SD above normal value); hemodynamic variables (arterial hypotension <90 mm Hg (<12.0 kPa) or MAP <70 mm Hg (<9.3 kPa), elevated mixed venous oxygen saturation of >70% (>0.70); CI >3.5 L/min (>0.058 L/s); organ-dysfunction variables (arterial hypoxemia; acute oliguria of <0.5 mL/kg/h or 45 mL/h for at least 2 h, creatinine increase >0.5 mg/dL (>0.44 μmol/L), coagulation abnormalities, paralytic ileus, platelets <100,000 /mm3 (<100 × 109/L), bilirubin >4 mg/dL (>68 μmol/L); tissue-perfusion variable (hyperlactatemia >1 mmol/L, decreased capillary refill)
Severe sepsis Sepsis associated with one or more organ dysfunctions, hypoperfusion, or hypotension. Hypoperfusion and perfusion abnormalities may include, but are not limited to, arterial hypoxemia (PaO2/FiO2<300) lactic acidosis, oliguria, increase in creatinine, coagulation abnormalities (INR>1.5), and elevated bilirubin
Septic shock Sepsis with persistent hypotension despite fluid resuscitation (intravenous uid of 30 mL/kg) or hyperlactatemia >1 mmol/L

CI, cardiac index; HR, heart rate; INR, international normalized ratio; RR, respiratory rate; SD, standard deviation; SIRS, systemic inflammatory response syndrome; T, temperature; WBC, white blood cell (count).

Adapted from Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med. 2003;31:1250–1256.

Reprinted with permission from Wells BG, DiPiro JT, Schwinghammer TL, et al. Pharmacotherapy Handbook. 10th ed. New York, NY: McGraw-Hill; 2017.

ETIOLOGY

  • Sites of infection that most frequently lead to sepsis:

    • Respiratory tract (39–50%)

    • Urinary tract (5–37%)

    • Intra-abdominal space (8–16%)

  • Caused by:

    • Gram-positive bacteria (37–47% of cases)

      • Common gram-positive pathogens:

        • Staphylococcus aureus

        • Streptococcus pneumonia

        • Coagulase-negative staphylococci.

        • Enterococcus species.

    • Gram-negative bacteria (38% of cases)

      • Most common isolates: Escherichia coli, Klebsiella spp., and Pseudomonas aeruginosa

      • P. aeruginosa associated with a higher mortality rate.

        ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.

This site uses cookies to provide, maintain and improve your experience. MHE Privacy Center Close