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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