Kumar and Parillo (1995) The state in which

profound and widespread reduction of

effective tissue perfusion leads first to
reversible, and then if prolonged, to
irreversible cellular injury
Shock Cardiogenic
Shock Distributive
Shock Hypovolemic
Shock Obstructive
 Septic Shock
Severe
Sepsis
Sepsis
Sepsis induced

SIRS
hypotension
despite
Sepsis + organ adequate fluid
2 or more of the dysfunction, resuscitation,
following : hypoperfusion, along with signs
(1)Temp > 38 or SIRS + or hypotension of hypoperfusion
<36 Suspected
(2)HR >90 infection
(3)RR >20 or
PaCO2 < 32
(4)WBC >12.000
or <4.000 or
>10% bands
The new definition life threatening organ
dysfunction caused by dysregulated host
response to infection
Septic shock subset of sepsis in which
underlying circulatiory and cellular/metabolic
abnormalities are profound enough to
substantially increase mortality
Nonspecific symptoms :
Fever, chills, and rigors
Confusion
Anxiety
Difficulty breathing
Fatigue and malaise
Nausea and Vomiting
 Head and neck infections

Chest and pulmonary infections

Cardiac infections

Abdominal and gastrointestinal infections

Pelvic and genitourinary infections

Bone and soft tissue infections

Skin infections
 ABC

Vital Sign

Head and Chest and Abdominal

Cardiac
Neck pulmonary and GI
Pelvic and
Bone and
genitourinar Skin
soft tissue
y
Laboratory
Complete blood count with differential
Coagulation PT, aPTT
Electrolytes
Blood Glucose
Serum lactate
Ureum/Creatinine
Procalcitonin
Others as indicated
Microbiology studies
Blood cultures with sensitivity test
Gram stain
Radiography, Ultrasonography, and etc
 Vasopresso
r

BP = SV x SVR

Inotropes

Fluid
 Anti
Infection bioti
cs
Inflammator Broad
spectrum
y response
Decrease Specific
d SVR