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Khie Chen
Parameter umum:
Suhu (temperatur rectal/core >38,3oC)
Hipotermia (temperatur rektal/core <36oC)
Frekuensi jantung >90x/menit atau
>2SD diatas nilai normal menurut umur
Takipnu >30x/menit
Perubahan status mental/kesadaran
Edema atau balan cairan positif (>20ml/kg/24jam)
Hiperglikemia (glukosa plasma>110 mg/dl) tanpa diabetes
Parameter inflamasi:
Lekositosis (Lekosit>12.000/ul)
Lekopenia (Lekosit<4.000/ul)
Lekosit normal dengan lekosit imatur/batang>10%
Peningkatan CRP > 2SD nilai normal
Peningkatan PCT > 2SD nilai normal
Parameter hemodinamik:
Hipotensi arterial
(tekanan sistolik <90 mmHg, MAP<70
atau tekanan sistolik turun >40mmHg pada dewasa)
Saturasi vena oksigen campuran (SmcvO2) >70%
Indeks kardiak >3.5 l/menit/m2
Chest 1992;101:1644
General Concept in
Management of Sepsis
Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. NEJM 2001;345:1368.
SUMMARY: SEPSIS GUIDELINES 2008
Strong Recommendation : Recommended
A B C D
Oxygenization
Fluid and volume resucitation
Vasopresor and inotropic
Albumine
Blood trasfusion
Nutrition
Blood glucose controlled
Renal dysfuction
Bicarbonate therapy
Corticosteroids
Coagulation disorders
Randomization
Conventional Intensive
Blood glucose level
when insulin infusion >215 mg/dL >110 mg/dL
was started