重庆医科大学：《重症医学》课程教学课件（讲稿，2017）Sepsis

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Y o u r C o m p a n y s l o g a n i n h e r e Sepsis

History of sepsis definitionKey dates in sepsis research4thBCE:discriminationcenturyprognosticbetweenandinfectionlocalisedsystemic(Hippocrates)and 2ndof1stCE:Fourfeaturescenturyinflammation-----red, swollen, fever, pain1878:introductionofthetermmicrobes(Sedillot)1879-1880:identification of microbes in the bloodof patientswithsepsis (Pasteur)1936:descriptionofstresssyndrome(Selye)1992:currentdefinitionofsepsis(Bone)02001: revisit the definition of sepsis (Levy)www.themeyallery.com

History of sepsis definition www.themegallery.com Key dates in sepsis research 4th century BCE: prognostic discrimination between localised and systemic infection (Hippocrates) 1 st and 2 nd century CE: Four features of inflammation-red, swollen, fever, pain 1878: introduction of the term microbes (Sedillot) 1879-1880: identification of microbes in the blood of patients with sepsis (Pasteur) 1936: description of stress syndrome (Selye) 1992: current definition of sepsis (Bone) 2001: revisit the definition of sepsis (Levy)

ContentsDefinition2Diagnosis of sepsisBasic mechanism of sepsis3History of the guidelines

Contents 4 History of the guidelines 1 2 3 Definition Diagnosis of sepsis Basic mechanism of sepsis

Sepsis---Burnswww.themegallery.com

Sepsis-Burns www.themegallery.com

Sepsis---BurnsFig 1Fig 2

Fig 1 Fig 2 Sepsis-Burns

Sepsis---Neonatal pustulosis

Sepsis-Neonatal pustulosis

DefinitionSystemic Inflammatory Response Syndrome(SIRS)SIRS is due to a wide variety of clinicalinsults manifested by two or more ofTemperature >38° C or 90Respiratory rate >20 or PaC0, 12×109/L or 10%immature neutrophils

Systemic Inflammatory Response Syndrome (SIRS) SIRS is due to a wide variety of clinical insults manifested by two or more of  Temperature >38°C or 90  Respiratory rate >20 or PaCO2 12×109/L or 10% immature neutrophils. Definition

DefinitionSepsisSepsis is defined as the presence (probableor documented) of infection together withSystemic Inflammatory Response Syndrome(SIRS)

Sepsis is defined as the presence (probable or documented) of infection together with Systemic Inflammatory Response Syndrome （SIRS）. Definition Sepsis

DefinitionSIRS-Sepsis-InfectionBacteremiaOtherInfectionSIRSSepsisFungemiTraumaParasiteVirusBurnsotherPancreatitis

Bacteremia Infection SIRS Pancreatitis Fungemia Other Trauma Burns Parasite Virus other Sepsis SIRS Definition -Sepsis-Infection

DefinitionSepsis、 Severe Sepsisand Septic ShockSepsis : sepsis without organ dysfunction.Severe sepsis : sepsis associated with organdysfunction, hypoperfusion or hypotension.Septic Shock: sepsis induced hypotensiondespite adequate fluid resuscitation alongwith perfusion abnormalities that may includelactic acidosis, oliguria, or an acutealteration in mental status

Sepsis、Severe Sepsis and Septic Shock Sepsis : sepsis without organ dysfunction. Severe sepsis : sepsis associated with organ dysfunction, hypoperfusion or hypotension. Septic Shock: sepsis induced hypotension despite adequate fluid resuscitation along with perfusion abnormalities that may include lactic acidosis, oliguria, or an acute alteration in mental status. Definition