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    Gambaran Klinis Dan Tatalaksana Sepsis

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    yunielsya
    This document discusses the clinical presentation and treatment of sepsis. It covers the definition, clinical manifestations, diagnosis, and management of sepsis. Key points include the pathophysiology, diagnostic criteria according to sepsis consensus guidelines, biomarker and microbiological testing, and therapeutic considerations according to surviving sepsis campaign guidelines.

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    Gambaran Klinis Dan Tatalaksana Sepsis

    Uploaded by

    yunielsya
    57 views35 pages
    This document discusses the clinical presentation and treatment of sepsis. It covers the definition, clinical manifestations, diagnosis, and management of sepsis. Key points include the pathophysiology, diagnostic criteria according to sepsis consensus guidelines, biomarker and microbiological testing, and therapeutic considerations according to surviving sepsis campaign guidelines.

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    Gambaran Klinis dan Tatalaksana Sepsis

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    This document discusses the clinical presentation and treatment of sepsis. It covers the definition, clinical manifestations, diagnosis, and management of sepsis. Key points include the pathophysiology, diagnostic criteria according to sepsis consensus guidelines, biomarker and microbiological testing, and therapeutic considerations according to surviving sepsis campaign guidelines.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    57 views35 pages

    Gambaran Klinis Dan Tatalaksana Sepsis

    Uploaded by

    yunielsya
    This document discusses the clinical presentation and treatment of sepsis. It covers the definition, clinical manifestations, diagnosis, and management of sepsis. Key points include the pathophysiology, diagnostic criteria according to sepsis consensus guidelines, biomarker and microbiological testing, and therapeutic considerations according to surviving sepsis campaign guidelines.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 35

    Gambaran Klinis dan Tatalaksana

    Sepsis
    Dr. Nadjirman
    PENDAHULUAN
    KONDISI > 50 JUTA
    SEPSIS MENGANCAM JIWA/TAHUN
    JIWA  SEPSIS

    26%
    (SEPSIS & SEPSIS BERAT)

    60%
    (SYOK SEPSIS)

    SEPSIS  sebagai respon yang


    merugikan dari sistem imunitas host
    terhadap patogen yang menyerang
    Batasan Masalah
    • Referat ini membahas definisi, gambaran
    klinis, diagnosis, tatalaksana pada Sepsis.
    Tujuan Penulisan
    • Referat ini bertujuan untuk menambah
    pengetahuan pembaca pada umumnya dan
    penulis khususnya mengenai definisi,
    Gambaran klinis, diagnosis tatalaksana Sepsis
    Metode Penelitian

    • Referat ini ditulis dengan menggunakan


    metode tinjauan pustaka yang merujuk dari
    berbagai literatur.
    Patofisiologi
    Gambaran Klinis
    Infection, documented or suspected, and some of the
    Inflammatory variables
    following:

    Leukocytosis (WBC count >12,000 μL−1)


    General variables

    Fever (>38.3 °C) Leukopenia (WBC count <4,000 μL−1)

    Hypothermia (core temperature <36 °C) Normal WBC count with greater than 10 %
    Heart rate >90 min−1 or more than two SD above the normal
    immature forms
    value for age
    Plasma C-reactive protein more than two SD
    Tachypnea

    Altered mental status above the normal value


    Significant edema or positive fluid balance (> 20 mL/kg Plasma procalcitonin more than two SD above
    over 24 h)
    the normal value
    Hyperglycemia (plasma glucose >140 mg/dL or 7.7

    mmol/L) in the absence of diabetes


    Hemodynamic variables

    Arterial hypotension (SBP <90 mmHg, MAP <70 mmHg, or an SBP decrease >40 mmHg in adults or less

    than two SD below normal for age)

    Organ dysfunction variables

    Arterial hypoxemia (PaO2/FiO2 <300)

    Acute oliguria (urine output <0.5 mL kg−1 h−1 for at least 2 h despite adequate fluid resuscitation)

    Creatinine increase >0.5 mg/dL or 44.2 μmol/L

    Coagulation abnormalities (INR >1.5 or aPTT>60 s)

    Ileus (absent bowel sounds)

    Thrombocytopenia (platelet count <100,000 μL −1)

    Hyperbilirubinemia (plasma total bilirubin >4 mg/dL or 70 μmol/L)

    Tissue perfusion variables

    Hyperlactatemia (>1 mmol/L)

    Decreased capillary refill or mottling


    Severe sepsis definition = sepsis-induced tissue hypoperfusion or organ dysfunction (any

    of the following thought to be due to the infection)

    Sepsis-induced hypotension

    Lactate above upper limits laboratory normal

    Urine output <0.5 mL kg−1 h−1 for more than 2 h despite adequate fluid resuscitation

    Acute lung injury with PaO2/FiO2 <250 in the absence of pneumonia as infection source

    Acute lung injury with PaO2/FiO2 <200 in the presence of pneumonia as infection source

    Creatinine>2.0 mg/dL (176.8 μmol/L)

    Bilirubin >2 mg/dL (34.2 μmol/L)

    Platelet count <100,000 μL

    Coagulopathy (international normalized ratio >1.5)


    Diagnosis
    IMPLIKASI KLINIS
    1. DILEMA DIAGNOSTIK 
    - Konsensus
    sepsis 1 (1991)
    - Sepis  respon
    sistemik
    terhadap infeksi
    - Konsensus sepsi
    2 (2001) 
    kriteria SIRS
    tidak terbukti
    - Konsensus sepsis 3
    definisi  disfungsi organ yang mengancam
    jiwa

    SOFA SCORE
     2 POIN
    BIOMARKER :
    - C- Reaktiv Protein
    - Prokalsitonin
    MIKROBIOLOGI :
    - Kultur darah ( gold standar)
    - PCR
    Tatalaksana
    DILEMA TERAPETIK

    Pedoman terbaru, berdasarkan SSC (Surviving


    Sepsis Campaign):
    - Deteksi dini sepsis
    - Pemberian awal antibiotik yang sesuai
    - Resusitasi caitan intravena dan vasopressor
    THANK YOU

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