Sepsis : A Systemic And Response Of The Immune System

The systemic inflammatory response is the next step in the continuum and is a nonspecific inflammatory state that may be seen with an infection. Sepsis is the presence of the systemic inflammatory response syndrome (SIRS) with evidence of infection. As the bacteria invade the bloodstream, they release endotoxins that damage the endothelial cell lining and impair the vascular system, coagulation mechanism, and immune system. These endotoxins also trigger the immune and inflammatory responses, which results in the activation of macrophages and CD4 cells that release proinflammatory cytokines to create a systemic inflammatory response to the pathogen. Hospitalized patients may quickly progress from bacteremia to sepsis and finally to septic shock, even with treatment.

Is aggressive widespread inflammatory response to infection (sepsis) or perceived invader. Also, ischemia, infarction and injury.

Sepsis is the number one cause of death in intensive care units in the U.S. More than 750,000 cases of sepsis occur each year and about one third of those patients die from it (McKinney, 2014; Ulloa, 2011). Sepsis is a serious condition that is a result of an inflammatory response to infection that can damage organs if left untreated. Severe sepsis occurs when the infection leads to organ dysfunction. Septic shock is when multiple organ failure occurs due to infection and is worse than sepsis and severe sepsis.

Sepsis is defined by the Surviving Sepsis Campaign (SSC) as “the presence (probable or documented) of infection together with systemic manifestations of infection” (Dellinger et al.,

Sepsis is a rapidly progressive illness that must be treated early with antibiotics and supportive care.

Under the Core measures, Sepsis is one of the problem-focused trigger for systemic infection and if untreated which can lead to death. In United States, it is the 11th leading cause of death and consumes the large amount of costs about $20.3 billion in 2011 (Jones et al.,2016). According to Centers for Disease Control and Prevention (CDC), more than 1.5 million people diagnosed with sepsis, and at least 250,000 patients die from that yearly (CDC, 2017). The evidence-based research revealed with results of certain pre existing conditions, pathophysiological studies, preventive measures and sepsis bundle for treating and preventing sepsis to save the life of the patients.

Sepsis is a life-threatening and potentially fatal condition caused by the body’s reaction to an infection. Sepsis occurs when chemicals normally released in the bloodstream to fight infection trigger inflammation throughout the body. This can result in damage to multiple organs, which can cause organ damage and, in some cases, death.

The evolution of this project cultivated from the need of improvement for patients suffering from sepsis at MacNeal Hospital. Sepsis is a potentially fatal host response to infection that occurs as a systemic inflammatory response syndrome (Schub & Schub, 2013). I felt it was very important to re-evaluate what I can do as a nurse to improve the expected outcomes of sepsis patients and decrease their length of hospitalization. If a patient is admitted with severe sepsis, it places the patient at a higher level of risk than if he/she was admitted with an acute myocardial infarction or acute stroke (Robson & Daniels, 2013). I became interested in sepsis as my project when I became informed that MacNeal had started a Patients With Sepsis Orders Daily Reports, I decided I could enhance and develop an educational tool to help the case managers, emergency room nurses, and staff nurses with early recognition of sepsis and decreasing the length of stay. Angus and Van der Poll (2013) stated that the United States reported 2% of patients that were admitted to the hospital suffered from severe sepsis.

This leads us to the next step in the pathophysiology of Sepsis. Stage 2 of sepsis, which is when SIRS plus the confirmation of an infection has been made. At this stage, the patient’s body has been continuously fighting something in their body and it is starting to have an effect on the patient. Signs and symptoms of sepsis are often nonspecific and include the following: Fever, chills, or rigors, Confusion, Anxiety, Difficulty breathing, Fatigue, malaise, Nausea and vomiting. It is important to identify any potential source of infection. Localizing signs and symptoms referable to organ systems may provide useful clues to the etiology of sepsis and are as follows: Head and neck infections: Severe headache, neck stiffness, altered mental

et al., 2008). Sepsis is a frequent cause of admission to intensive care units (ICUs) and it

Education interventions are very significant in the understanding of different stages of sepsis such as septic shock, uncomplicated sepsis, and severe sepsis. The progression of this disease varies from one person to another, and it can occur to some people through the three stages. Therefore, having a clear understanding of all the three phases that sepsis exists can help in the diagnosis of the diseases effectively. Additionally, education will provide an avenue and strategy of providing optimal care to the patient, and that will contribute to managing their condition. Sometimes the patients may not respond to the treatment administered, and as a result, they can develop multiple organ diseases. Hence, education will provide all the required knowledge to understand and know the various dynamic of the diseases and how it progress in a patient.

The exact definitions, stratification, and approach to diagnosis of the sepsis spectrum has been a persistent, yet seemingly productive, endeavor for many years1,5,16. Multiple consortiums have addressed the approach to diagnosing sepsis. In 1992, a consortium, comprised of the American College of Chest Physicians and the Society of Critical Care Medicine, instituted the Systemic Inflammatory Response Syndrome (SIRS) criteria which established the fundamental screening tool for identifying individuals with an inflammatory immune response (Table 1)5. A patient exhibiting two or more of the SIRS criteria combined with the presence or suspicion of infection was the fundamental criteria for sepsis diagnosis5. Although this approach is of merit, it is too broad. Patients recovering from surgery or suffering from various non-infectious processes would meet the criteria for sepsis under SIRS17,18. An exhaustive list of exogenous and endogenous processes may generate a SIRS-inclusive response in the absence of infection18. A criteria with greater specificity was greatly needed.

Sepsis was known in the old days as "blood Poisoning" because it is " A poisoning of the system by disease carrying bacteria and their toxins absorbed into the bloodstream, as from festering wounds," according to the World Book Encyclopedia Dictionary. 1 Because Sepsis is a severe and often fatal disease and thought to cause 44,000 deaths a year, it is most important that it be recognized early and treated aggressively with utmost and urgent care. If not treated early it can lead to shock and multiple organ failure and even death. It kills more people than breast, bowel, and prostate cancer combined; however, it can be treated successfully if detected early on. 2. Erin Dean Sepsis does not arise on its own. It stems from another medical condition such as an infection in the lungs, urinary tract, skin, abdomen (such as appendicitis) or other part of the body. Invasive medical procedures like the insertion of a vascular catheter can introduce bacteria into the bloodstream and bring on the condition. Many different types of microbes can cause sepsis, including bacteria, fungi and viruses, but bacteria are the most common culprits. Severe cases often result from a body-wide infection that spreads through the bloodstream, but sepsis can also stem from a localized infection.

Sepsis is a critical condition caused by an overreacting immune response to an infection. Most of the time, such infection are caused by bacteria. When a person is being infected, chemicals are released into the bloodstream to fight off infection. This may result in multiples inflammation found within the body. Inflammation can trigger a cascade of event which may cause multiple organ damage, leading to multiple failure of organs where the body is unable to function normally. In worst scenario, infection can lead to an increase in low blood pressure which rapidly leads to the failure of several organs causing death. Besides causing inflammation, it also causes increased in coagulation, decreased fibrinolysis and decreases the

The term “sepsis” has been around since prehistoric times. Hippocrates presented the word sepsis 2400 years ago to represent a condition where an overwhelming infection leads to tissue breakdown with rotting, foul odour, and disease. The ancient Roman scholar and writer (116 BC–27 BC), Marcus Terentius Varro mentioned that “small creatures, invisible to the eye, fill the atmosphere, and breathed through the nose cause dangerous diseases.”