SEVERE SEPSIS & SEPTIC SHOCK

Up Objectives Schedule Faculty

OBJECTIVES

Describe the pathophysiology of severe sepsis and septic shock.

Discuss the use of inotrope and vasopressor drugs in caring for the patient with septic shock.

Describe the role of SvO2 and ScvO2 in optimizing hemodyamic support of the patient with septic shock.

Discuss mean arterial pressure, including definition, therapeutic goals, and pharmacologic support.

Define oxygen extraction ratio (ERO2).

Describe the relationship between nitric oxide release by the red blood cell and improved blood flow in hypoxic tissues.

Explain the role of global left ventricular hypokinesis resulting in cardiovascular dysfunction in the pathogenesis of septic shock.

Discuss current research findings which indicate that failure to mount a hyperdynamic response during septic shock is associated with increased mortality.

Explain the pathogenesis of elevated lactate levels in severe sepsis and septic shock.

Discuss research findings which show blood lactate levels superior to oxygen-derived variables as a prognostic marker in septic shock.

Describe the importance of significant microcirculatory disturbances and early organelle injury in severe sepsis and septic shock.

Discuss the role of source control as a key component of the clinical management of the patient with severe sepsis or septic shock.

Describe how ScvO2 and SVO2 monitoring can identify global tissue hypoxia, aid in detecting septic shock, and potentially be of benefit in prevention of MODS.

Explain why higher plasma concentrations of antibiotics may be required to achieve the target concentrations needed in the tissues of the patient with septic shock.

Explain why monitoring serum levels of antibiotics is important in the patient with severe sepsis undergoing treatment with ECMO.

Identify the intervention most strongly correlated with survival in the patient with septic shock.

Differentiate the terms “preload” and “preload responsiveness.”

Discuss why determination of preload responsiveness is superior to giving a rapid fluid bolus to detect the need for additional fluid therapy in the patient with septic shock.

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