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The SOFA scoring system is useful in predicting the clinical outcomes of critically ill patients. [8] According to an observational study at an Intensive Care Unit (ICU) in Belgium, the mortality rate is at least 50% when the score is increased, regardless of initial score, in the first 96 hours of admission, 27% to 35% if the score remains unchanged, and less than 27% if the score is reduced. [9]
Sepsis is defined as SIRS in response to an infectious process. [48] Severe sepsis is defined as sepsis with sepsis-induced organ dysfunction or tissue hypoperfusion (manifesting as hypotension, elevated lactate, or decreased urine output). Severe sepsis is an infectious disease state associated with multiple organ dysfunction syndrome (MODS) [9]
Begg says sepsis mortality in developed countries like the UK is about 15%, but warns that many surviving patients suffer from the consequences of sepsis, which can include amputated limbs, for ...
SIRS is also closely related to sepsis, in which patients satisfy criteria for SIRS and have a suspected or proven infection. [2] [3] [4] [7] Many experts consider the current criteria for a SIRS diagnosis to be overly sensitive, as nearly all (>90%) of patients admitted to the ICU meet the SIRS criteria. [8]
Septic shock is a result of a systemic response to infection or multiple infectious causes. The precipitating infections that may lead to septic shock if severe enough include but are not limited to appendicitis, pneumonia, bacteremia, diverticulitis, pyelonephritis, meningitis, pancreatitis, necrotizing fasciitis, MRSA and mesenteric ischemia.
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APACHE II ("Acute Physiology and Chronic Health Evaluation II") is a severity-of-disease classification system, [1] one of several ICU scoring systems.It is applied within 24 hours of admission of a patient to an intensive care unit (ICU): an integer score from 0 to 71 is computed based on several measurements; higher scores correspond to more severe disease and a higher risk of death.
Elbers and Ince have identified five classes of abnormal microcirculatory flow in distributive shock using side stream dark field microscopy. Class I: all capillaries are stagnant when there is normal or sluggish venular flow. Class II: there are empty capillaries next to capillaries that have flowing red blood cells.