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Self-Assessment Questions

Pulmonary Disease

Answer 1
  1. Severe sepsis. The patient fulfills criteria for severe sepsis, defined as sepsis with evidence of organ dysfunction, hypoperfusion, or hypotension. SIRS is defined as an inflammatory response to insult manifested by 2 of the following: temperature greater than 38°C (100.4°F) or less than 36°C (96.8°F), heart rate greater than 90 bpm, respiratory rate greater than 20 breaths/min, and white blood cell count greater that 12 × 103/µL, less than 4 × 103/µL, or 10% bands. A diagnosis of sepsis is given if infection is present in addition to meeting criteria for SIRS. Septic shock includes sepsis-induced hypotension (despite fluid resuscitation) along with evidence of hypoperfusion. MODS is the presence of altered organ function such that hemostasis cannot be maintained without intervention.1 This patient’s lack of fluid resuscitation classifies him as having severe sepsis rather than septic shock.

    1. Bone RC, Balk RA, Cerra FB, et al. Definition for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992;101:1644-55.

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