Sepsis and Septic Shock in Pregnancy - Children's Memorial ...

More documents

Recommendations

Info

Later Goal Directed Therapy• Complete within 24 hours• Initially recommended– Administer “physiologic” steroids– Administer drotrecogin alpha• WRONG per PROWESS-SHOCK Trial 2011– Tight glucose control (80-110 mg/dl)• WRONG per NICE-SUGAR study 2009and VISEP Trial 2008Rivers E et al, N Eng J Med 2001
Mortality (%)The Importance of Early Goal-DirectedTherapy (EGDT) for Sepsis Induced HypoperfusionNNT to prevent 1 event (death) = 6 to 860 Standard therapy50EGDT403020100In-hospitalmortality(all patients)28-daymortality60-daymortalityAdapted from Rivers E, Nguyen B, Havstad S, et al. N Engl J Med 2001;345:1368-1377 Table 3, page 1374
Page 1 and 2: Sepsis and Septic Shockin Pregnancy
Page 3 and 4: Cases / 100,000Deaths/YearCompariso
Page 5 and 6: Maternal mortality, 1842“It is no
Page 7 and 8: The Intervention:Hand scrub with ch
Page 9 and 10: Definitions• Sepsis- SIRS due to
Page 11 and 12: Case History• 31 wks, sore throat
Page 13 and 14: Group A StreptococcusThe Etiology,
Page 17 and 18: MicroabscessFascia
Page 19: Early Goal Directed Therapy• Earl
Page 23 and 24: Algorithm for Septic Shock in Pregn
Page 25 and 26: Antimicrobial Therapy• Infection
Page 27 and 28: Post-op C/SMultilocularabscessDispl
Page 29 and 30: Postpartumnecrotizingfasciitis
Page 31 and 32: Empiric Antimicrobial Therapy• Ge
Page 33 and 34: Vasoactive Therapy• Indication- H
Page 35 and 36: Corticosteroids• Treat patients w
Page 37 and 38: Presentation: Temp 103.5, severe fl
Page 39 and 40: Maintenance PhaseAnticipation of co
Page 41 and 42: H1N1 influenza-associated ARDS: Bil
Page 43 and 44: Indications for surgical interventi
Page 46 and 47: Obesity Trends*Among U.S. AdultsDon
Page 48 and 49: Outcome
Page 50 and 51: References• Mabie WC, Barton JR,
Page 52 and 53: References• Walsh C, Scaife C, Ho
Page 54 and 55: References• Kitter ND, McMullen K
Page 56 and 57: Historical Guidelines for Sepsis Th
Page 58 and 59: Probability of SurvivalFluid Resusc
Page 60 and 61: Drotrecogin Alfa (Xigris)• Decrea
Page 62 and 63: VentricularFunctionGroup INormalGro
Page 64 and 65: Varicella-Zosterin Pregnancy
Page 66: BACKGROUNDGlobal• Puerperal sepsi

Sepsis and Septic Shock in Pregnancy - Children's Memorial ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?