Professional Documents
Culture Documents
an Overview
Microorganisms represent
the first species of living organisms
that populated our planet
and will probably continue
to survive well
beyond the extinction
of the human race
(Fasano, 2002)
Severe Sepsis:
A Significant Healthcare Challenge
Severe Sepsis is a
Significant Healthcare
Burden
Sepsis consumes significant healthcare
resources.
In a study of Patients who contract
nosocomial infections, develop sepsis and
survive:
ICU stay prolonged an additional 8 days.
Additional costs incurred were $40,890/ patient.
: 20%
: 45%
In recent 2 years:
mortality rate of severe sepsis
mortality rate of septic shock
: 31%
: 64%
Definisi
Sepsis adalah: adanya bukti atau kecurigaan
kuat adanya infeksi, yang disertai tanda-tanda
sindroma respon inflamasi sistemik (SIRS:
Systemic Inflammatory Response Syndrome)
yang meliputi 2 atau lebih tanda di bawah ini:
- suhu badan 38C, atau 36C
- nadi 90 kali/menit
- respirasi 20 kali/menit atau P CO2 arteri <
32 mmHg
- angka lekosit 12000/mmk atau 4000/mmk
atau
sel lekosit muda > 10%
SIRS
Sepsis
Severe
Sepsis
SIRS with a
presumed or
confirmed
infectious
process
SIRS = Systemic Inflammatory Response
Syndrome
www.themegallery.com
Question: Why do
Septic Patients Die?
Answer: Organ
Failure
IMUNOPATOGENESI
S
C3a, C5a
IMUNO.COM
APC
LPS
CD 4+
CD 14
TLR
IFN -
TLR2
MOD
PaI-1
SHOCK
SEPTIC
SUPER ANTIGEN
LPS bp
C7a
SEPSIS
(Guntur, 2000)
IL 8
IL 6
IL -1
PGE
TH - 1 TH - 2
NO
ICAM -1
IL - 10
IL - 4
IL - 5
IL - 6
B cell
CSF
N
Compl.
TNF -
TCR
Ig
IL-2
CD 8+
TF-VIIA
NK
Diagnosis
Initial Resuscitation
Antibiotic therapy
Source Control
Fluid Therapy
Vasopressors
Inotropic Therapy
Steroids
Recombinant Human
Activated Protein C
Blood Product
Administration
Mechanical Ventilation of
Sepsis-Induced Acute
Lung Injury
L.
Summary
Sepsis:
Significant Healthcare Challenge &
Burden
The complexity of Sepsis:
Organisms,
Pathophysiology and
Management