SÍNDROME DE RESPUESTA INFLAMATORIA SISTEMICA

Antecedentes

GUIDELINE, Bone RC. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCAM Consensus Conference Commmittee. 1992

Noruega en febrero de 1983. Dr. William R. Nelson

Antecedentes

GUIDELINE, Bone RC. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCAM Consensus Conference Commmittee. 1992

Body temperature less than 36°C or greater than 38°C

Heart rate greater than 90 beats per minute Tachypnea (high respiratory rate), with greater

than 20 breaths per minute; or, an arterial partial pressure of carbon dioxide less than 4.3 kPa (32 mmHg)

White blood cell count less than 4000 cells/mm³ (4 x 109 cells/L) or greater than 12,000 cells/mm³ (12 x 109 cells/L); or the presence of greater than 10% immature neutrophils (band forms).

GUIDELINE, Bone RC. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCAM Consensus Conference Commmittee. 1992

Preambulo

Infección.

Bacteremia.

Sepsis.

Choque septico.

Rangel-Fausto MS. The natural history of the systemic inflammatory response syndrome (SIRS).A prospective study.JAMA 2005

Causas

Heffner AC. Horton JM. Etiology of illness in patients with severe sepsis admitted to the hospital from the emergenncy department. Clinc infect. March 2010

Epidemiologia

Rangel-Fausto UCI 68%. 26% sepsis. 4-8% choque septico.

Angus DC. Linde-Zwirble WT. Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome, and associated costs of care. Crit care Med . 2001Rangel-Fausto MS. The natural history of the systemic inflammatory response syndrome (SIRS).A prospective study.JAMA 2005

Fisiopatologia

Presentacion Historia clinica

Comstedt P. The systemic Inflammatory response Syndrome in acutely hospitalised medical patients.Emerd Med . Dec 2010

Comstedt P. The systemic Inflammatory response Syndrome in acutely hospitalised medical patients.Emerd Med . Dec 2010

Presentacion

Examen fisico.

Revision cuidadosa de los signos.

Comstedt P. The systemic Inflammatory response Syndrome in acutely hospitalised medical patients.Emerd Med . Dec 2010

Presentacion

Comstedt P. The systemic Inflammatory response Syndrome in acutely hospitalised medical patients.Emerd Med . Dec 2010

Complicaciones

Falla respiratoria, síndrome de insuficiencia respiratoria aguda (ARDS), y neumonía nosocomial.

Fallo renal. Sangrado gastrointestinal y gastritis de

stress. Anemia. TVP. Desequilibrio hidroelectrolitico. Coagulación intravascular diseminada.

Rangel-Fausto MS. The natural history of the systemic inflammatory response syndrome (SIRS).A prospective study.JAMA 2005

Educacion

Pronostico

Las tazas de mortalidad mencionadas por Rangel-Faus study fueron de 7% (SIRS), 16% (sepsis), y 46% (choque septico).

Los pacientes hospitalizados con SIRS presentan una taza de mortalidad de 6.8 mayor a los que no padecen.

Angus DC. Linde-Zwirble WT. Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome, and associated costs of care. Crit care Med . 200Rangel-Fausto MS. The natural history of the systemic inflammatory response syndrome (SIRS).A prospective study.JAMA 20051