Понимание сепсиса и септического шока (Визуальное руководство) | Обновленный урок 2024 скачать в хорошем качестве

Понимание сепсиса и септического шока (Визуальное руководство) | Обновленный урок 2024

Wanna learn how I made this video? Check out the playlist:    • Make A Video With Me   Content: 0:00 Introduction 00:36 Content 01:05 Definition 01:33 Pathophysiology 05:40 Causes 06:46 Clinical Features 08:00 Clinical Criteria 09:29 Measures/Treatment 11:10 Clinical Scenario Example -- 🫀 Help me create more free educational content:    / @taimtalksmed   📷 INSTAGRAM   / taimtalksmed   ☕ Donation: https://www.buymeacoffee.com/TaimTalk... -- Sepsis Overview: Sepsis is a life-threatening condition where the body’s immune system reacts excessively to an infection, causing tissue and organ damage In 2017, there were 48.9 million cases globally and 11 million deaths. Sepsis affects anyone but is more common in the elderly, young, pregnant women, or those with chronic health conditions. Definition: Sepsis occurs when an infection triggers a chain reaction in the body Pathophysiology of Sepsis: 1.Infection triggers immune response: The immune system overreacts to infections (bacterial, viral, fungal, or parasitic) 2-Release of cytokines: Cells release IL-1, IL-6, TNF-α, and other mediators, causing inflammation. 3.Vasodilation and permeability: Blood vessels dilate and leak, leading to hypotension 4-Decreased cardiac output: Blood volume drops, reducing oxygen delivery to organs 5.Tissue hypoxia and acidosis: Lack of oxygen leads to lactic acid build-up. 6.Coagulation: Impaired blood clotting results in DIC. 7-Multi-organ dysfunction: Key organs (heart, lungs, kidneys) are affected. 8-Septic shock: Persistent low blood pressure without treatment can lead to septic shock. Causes of Sepsis: -Bacterial infections: Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa are common. -Viral infections: Influenza and COVID-19. -Fungal infections: Candida and Aspergillus. -Parasitic infections: Malaria (Plasmodium). -Infection sources: Pneumonia, urinary tract infections, abdominal infections, and skin infections. -Healthcare-associated infections: Infections from catheters, ventilators, or surgery. -Weakened immunity: People with compromised immune systems (chemotherapy, organ transplants) are more vulnerable. Clinical Features (TIME mnemonic): T - Temperature: High fever or low temperature I - Infection signs: Symptoms vary (e.g., cough, shortness of breath, abdominal pain) M - Mental status: Confusion or difficulty waking E - Extremely ill: Severe discomfort, pain, and shortness of breath Clinical Criteria for Diagnosing Sepsis: 1,Infection suspected (bacterial, viral, fungal, or parasitic) 2.qSOFA score: Systolic BP ≤ 100 mmHg Respiratory rate ≥ 22 breaths/min Altered mental status qSOFA score ≥ 2 suggests higher risk 3.NEWS score: NEWS ≥ 5 predicts sepsis risk based on RR, BP, and oxygen levels. Treatment for Sepsis: Blood cultures: Obtain before starting antibiotics. Lactate levels: Elevated lactate (≥ 2 mmol/L) indicates tissue hypoxia. Urine output: Monitor for over 0.5 mL/kg/h to assess kidney function. IV fluids: Start 30 mL/kg within the first hour to treat hypotension. Oxygen therapy: Maintain oxygen saturation ≥ 94% (unless chronic respiratory issues are present). Antibiotics: Administer broad-spectrum antibiotics within the first hour. Vasopressors: If fluids fail to restore BP, use vasopressors (e.g., norepinephrine) to maintain a MAP ≥ 65 mmHg. Monitoring: Track blood pressure, lactate, and urine output to ensure effective treatment. Clinical Scenario Example: Assessment: Patient with low BP (88 mmHg), rapid breathing, and confusion. Treatment: Start IV fluids, monitor BP, administer vasopressors if needed, give antibiotics immediately. Sources: WHO. Global report on sepsis: current evidence, gaps, and future directions. Geneva: WHO; 2020. Harrison's Principles of Internal Medicine, 21e. Evans L, Rhodes A, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for sepsis and septic shock. Guarino M, Perna B, et al. Update on Sepsis and Septic Shock in Adults. Jacobi J. Pathophysiology of sepsis. CDC. Sepsis. 2024.