MANAGEMENT OF CRISES DURING ANESTHESIA AND SURGERY. PART XV: SEPSIS

Abstract

Altered mental status Tachypnea Fever (> 38.3°C) or Hypothermia (core temperature < 36°C) Heart rate > 90/min Arterial hypotension (sBP < 90 mmHg) Arterial hypoxemia (PaO2/FiO2 < 300) Decreased capillary refill or mottling Acute oliguria (urine output < 0.5 ml/kg/hr for at least 2 hrs despite adequate fluid resuscitation) Ileus (absent bowel sounds) Significant edema or positive fluid balance (> 20 mL/kg over 24 hours) Hyperglycemia (plasma glucose >140 mg/dl) in the absence of diabetes Leukocytosis (WBC count >12,000/μl), leukopenia (WBC count < 4,000/μl) or normal WBC count with greater than 10% immature forms High serum creatinine High Plasma C-reactive Coagulation abnormalities (INR >1.5 or a PTT >60 sec) Thrombocytopenia (platelet count <100,000/μl) Hyperbilirubinemia (plasma total bilirubin >4 mg/dl) Unexplained metabolic acidosis Evidence of disseminated intravascular coagulopathy Postoperative respiratory failure Failure to reverse