Management and Diagnosis of Sepsis and Septic Shock

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2 Comments

ivette.r.davis@*.com

Mar 08 2023, 5:43 pm

Great lecture. Sepsis is so intimidating to me and this tool gives me mor insight about management in the ICU.

ejhang@*.com

Jan 16 2023, 1:04 pm

Nice lecture! I kind of disagree with not giving more IV fluids. I've been hospitalized recently with septic shock with a lactic acid of 4.9. The IV saline helps the shooting pains and lowers my LA and after 1 bag 1000ml of LR I was still at 2.8. Also there seems to be some debate over Lactated Ringers and Normal Saline and kidney damage. A nurse at NYU told me that LR could damage my kidneys it does contain potassium. I kind of like lots of saline for the pain when I have high lactic acid and acidosis. Sometimes during severe infection LR causes pain in the upper back. I also wonder about pressors with decent blood pressure like 100/70 105/70, does this reduce oxygen and blood flow to the heart and kidneys and brain and lungs and all organs?

luisverduzco1981@*.com

Jan 15 2023, 7:46 pm

Hi, thank you for your thoughts! I think 1-2 liters of IVF is reasonable but recall that the majority of fluid given will go into the extracellular space in only a few hours (recall you had a normal amount of fluid in your vessels prior to vasodilatation from sepsis). The treatment is the underlying condition leading to shock. Inflammation worsens capillary leakage and hypotension increases inflammation; starting pressors early normalizes the BP and therefore would be expected to lower inflammation. Re LR vs NS, the potassium in LR is 4 mEq/L so even if I gave you an infinity amount of LR, your body's potassium would then reach 4. In fact, in patients undergoing renal transplants who are randomized to LR vs NS during the procedure, none of the patients in the LR group required treatment for high K but the NS group did--this is due to K shift from non-anion gap acidosis.

Dr. Luis A. Verduzco Intensivist, Anaesthesiologist Dr. Verduzco presents the diagnosis, labs, pathophysiology, and management of sepsis and septic shock.

Learning objectives of this video are the following:

1. Systemic Inflammatory Response Syndrome (SIRS)

2. Sepsis definition

3. Lactate and Procalcitonin

4. Practical approach to septic shock

5. Clinical scenarios

Presented by Dr. Luis A Verduzco

Following answers are created by ChatGPT. Occasionally the answer may be harmful, incorrect, false, misleading, incomplete, or limited in knowledge of world. Please contact your doctor for all healthcare decisions. Also, double check the answer provided by the AI below.

Author declares no conflict of interest.

In addition to the presenter, following authors who may have helped with the content writing, review, or approval declare no conflict of interest.

Luis A Verduzco M.D.
Dr. Pei Purdom (DNP)
Dr. Benish Zahra
Dr. Iqra Batool
Dr. Heba Alzawahri

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