Hilda Cristina Rodriguez MD

Emergenciologa
Causas de SIRS
 SEPSIS
Life-threatening organ dysfunction caused by a dysregulated host response to infection
Vincent JL, Moreno R, Takala J, et al; Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. The SOFA (Sepsis-
related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med. 1996;22(7):707-710.
SEPSIS

(Glasgow Coma Score of 13 or less)

 SEPSIS
Ileus (absent bowel sounds)
 SHOCK SEPTICO

Patients with septic shock can be clinically identified by a vasopressor requirement

to maintain a mean arterial pressure of 65 mm Hg or greater and serum lactate
level greater than 2 mmol/L (>18 mg/dL) in the absence of hypovolemia.
The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) JAMA. 2016;315(8):801-810.
 DIAGNOSTICO

Determinar la fuente
• Hemocultivos
• Orina
• LCR
• Heridas
• Secreciones pulmonares
• Imágenes
 BACTEREMIA
• Presence of viable bacteria (fungi) in the blood,
as evidenced by positive blood cultures.
• Positive cultures are not obligatory in the
diagnosis of sepsis.
• Only 17 to 27% of patients with sepsis, and
69% of patients with septic shock actually had
positive blood cultures.
• More than 30% of patients with sepsis do not
have a definite microbiologic diagnosis.
TRATAMIENTO
TERAPIA HÍDRICA
METAS 6 PRIMERAS HORAS
VASOPRESORES
INOTROPICOS
TRANSFUSIONES
PLAQUETAS
CORTICOIDES
Control de la glucosa
Profilaxis
Profilaxis
Terapia renal