SEPSIS

GROUP MEMBERS

 ABENA YEBOAH KWARTENG

 GIDEON ANTWI BOADI
 BENEDICTA ABENA YALLEY
 JOSEPH ANSAH KWAME
 STEPHANIE SOSU DELALI
PRESENTATION OUTLINE

 INTRODUCTION
 EPIDEMIOLOGY
 PATHOPHYSIOLOGY
 CLINICAL MANIFESTATION
 RISK FACTORS
 COMPLICATIONS
 INVESTIGATION
 DIAGNOSIS
 MANAGEMENT.
 REFERENCES.
INTRODUCTION

 Sepsis also known as septicemia is a life threatening complication of an

infection.
 It arises when the body’s response to an infection injures its own tissues and
organs.
 When the infection- fighting processes turn on the body, they cause organs to
function poorly and abnormally.
 Sepsis can lead to shock, multiple organ failure and death especially if not
recognized early and treated promptly
 Sepsis remains the primary cause of death from infection despite advances in
modern medicine, including vaccines, antibiotics and acute care.
EPIDEMIOLOGY

The incidence of sepsis varies among the different racial and ethnic group, but
appears to be highest among African-American males
The incidence is also greatest during the winter, probably due to the increased
prevalence of respiratory infections.
Older patients of 65 years or more account for majority (60 to 80 percent) of all
episodes of sepsis; with an increasing aging population, it is likely that the
incidence of sepsis will continue to increase in the future.
EPIDEMIOLOGY

 Gram positive bacteria are most frequently identified in patient.

 Cases of Gram negative sepsis remains substantial.
 The incidence of fungal sepsis has increased over the past decade , but
remains lower than bacterial sepsis.
 In half cases of sepsis, an organism is not identified.
EPIDEMIOLOGY
CLINICAL MANIFESTATIONS

 Fast Heart Rate : Change in systolic blood pressure – the first number in a
blood pressure reading is less than or equal to 100mmHg
 Fever or Hypothermia(very low body temperature)
 Shaking or Chills
 Warm or sweaty skin
 Confusion or Disorientation: Change in mental status
 Hyperventilation(rapid breathing or shortness of breath): Respiratory rate
higher than or equal to 22 breaths a minute
PATHOPHYSIOLOGY

 Multiple Organ Dysfunction and results from diffuse cell injury

 Mechanisms of cell injury/Death:
1. Cellular Necrosis(ischemic Injury)
2. Apoptosis
3. Leukocyte-mediated tissue injury
4. Cytopathic Hypoxia
PATHOPHYSIOLOGY
CAUSES OF SEPSIS

 While any type of infection bacterial, viral or fungal can lead to sepsis.
 Infections that more commonly can lead to sepsis include infections of;
 Lungs such as pneumonia
 Kidney, bladder and other parts of the urinary system.
 Digestive system
 Bloodstream (bacteremia)
 Catheter sites
 Wounds or burns
RISK FACTORS

 Several factors increase the risk of sepsis, including

 Older age
 Infancy
 Compromised immune system
 Diabetes
 Chronic kidney or liver disease
 Admission to intensive care unit or longer hospital stays
 Invasive devices such as intravenous catheters or breathing tubes
 Previous use of antibiotics or corticosteroids.
INVESTIGATIONS

 Blood Tests are used to test for:

1. Evidence of infection
2. Clotting problems
3. Abnormal liver or kidney function
4. Impaired oxygen availability
5. Electrolyte imbalances
 Urine Tests
 Wound Secretions
 Respiratory secretions
 Imaging Tests(X-Ray, Ultrasound, Computerized Tomography etc.)
COMPLICATIONS

 As sepsis worsens blood flow to vital organs such as the brain, heart and
kidneys becomes impaired.
 Sepsis may cause abnormal blood clotting that results in small clots or burst
blood vessels that damage tissues
 MANAGEMENT

 MEDICATIONS
 Antibiotics :Treatment with antibiotics begins as soon as possible. Broad-
spectrum antibiotics, which are effective against a variety of bacteria, are
usually used first. Eg, Azithromycin, Tetracycline and quinolones
 In principle, there are three main antibiotic targets in broad spectrum
antibiotics:
1. The cell wall or membranes that surrounds the bacterial cell
2. The machineries that make the nucleic acids DNA and RNA
3. The machinery that produce proteins(the ribosomes and associated proteins)
MANAGEMENT

 Intravenous fluids; the use of intravenous fluids begins as soon as possible.

Both Normal saline and Lactated Ringers solution are essentially isotonic and
have equivalent volume restorative properties. Fluid resuscitation should not
be delayed to use a balanced salt solution if NS is the only fluid available.

 Vasopressors; if the blood pressure remains too low even after receiving
intravenous fluids you may be given a vasopressor medication. This drug
constricts blood vessels and helps increase blood pressure. Eg are
Dobutamide, Epinephrine, Phenylephrine etc.
MANAGEMENT

 Also, other medications include low doses of corticosteroids. The rationale for
the use of corticosteroids in sepsis , is that this class of drugs down regulates
the exuberant and dysfunctional pro-inflammatory response, limits the anti-
inflammatory response while at the same time preserving innate immunity.
Eg. Prednisolone, Methylprednisolone, Hydrocortisone etc.

 Insulin to help stabilize blood sugar levels. The use of intensive insulin
therapy to maintain blood glucose level below 8.3mmol/L is recommended for
management of severe sepsis.
MANAGEMENT

 Drugs that modify the immune system responses. During sepsis, systemic
activation of the innate immune system by PAMPs and DAMPs results in a
severe and persistent inflammatory response characterized by excessive
release of inflammatory cytokines such as IL-1,TNF and IL-17
 Painkillers or sedatives. Examples of sedatives include benzodiazepines
ADVERSE REACTION

 Antibiotics
1. Diarrhoea
2. Vomiting
3. Rashes
 Corticosteroids
1. Weight Gain
2. Increased Appetite
3. High Blood Pressure
ADVERSE REACTION

 Vasopressors
1. Increased Heart Rate
2. Heart Attack
3. Stroke
COUNSELING

 NON-PHARMACOLOGICAL
 Wash your hands often with soap.
 Try to stay away from people who have a cold or flu
PHARMACOLOGICAL
 Antibiotics should not be taken with milk. This is because the calcium in the
milk binds the antibiotic and prevents gut absorption.
 Sedatives such as benzodiazepines should not be taken with alcohol.

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