Infections & Sepsis
The systemic inflammatory response to infec-tion, termed sepsis syndrome (Figure 57–8), does not necessarily indicate the presence of bactere-mia. Moreover, the inflammatory response is not unique to severe infections: similar manifestations may be encountered with noninfectious illnesses.
The use of the term systemic inflammatory responsesyndrome (SIRS) has been suggested by the Soci-ety of Critical Care Medicine (SCCM), European Society of Intensive Care Medicine (ESICM), American College of Chest Physicians (ACCP), American Thoracic Society (ATS), and Surgical Infection Society (SIS) (Table 57–10). A combined conference of the preceding long list of societies classified sepsis based on predisposition, insult, infection, response, and organ dysfunction. Severe sepsis exists when these features are associated with organ dysfunction. The term multiple organdysfunction syndrome (MODS) has been suggestedto describe dysfunction of two or more organs associated with sepsis. Septic shock is defined as acute circulatory failure in a patient with sepsis or, more specifically, systolic blood pressure less than 90 mm Hg that is not responsive to volume resus-citation and requiring vasopressors for life support.
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