- the effects of endotoxins have been blamed for all the effects of Gm neg septicemia;
- hyperpyrexia, vasoconstriction followed by vasodilation, ...
- the initial clinical symptom of bacilemia is usually a shaking chill;
- it is not unusual for the patient to initially have an elevated BP followed by a marked fall in blood pressure;
- often drops to shock levels within 4 hrs;
- leukopenia is not unusual but is followed shortly by a leukocyte count of 18,000 to 25,000;
- shortly after the shaking chill, the temperature rises to 103 (39.4) to 104 (40.0) or even higher;
- this is usually associatted with mental confusion;
- the pt becomes severely hypovolemic and acidotic and has hyper-coagulation, cardiac stress, and depressed urine volumes due to renal
tubular disassociation if this chain of events is not stop;
- renal shutdown may be bypassed by the use of diuretics (Lasix or Mannitol), provided a large amount of replacement fluid is given;
- Lasix 40 mg IV or Mannitol in the form of Osmitrol 250 cc of a 10% sol. may be utilized
Concepts in Emergency and Critical Care: Pathogenesis of Disseminated Intravascular Coagulation in Sepsis.
Concepts in Emergency and Critical Care: Effect of Stored-Blood Transfusion on Oxygen Delivery in Patients With Sepsis.
Concepts in Emergency and Critical Care: Reevaluation of the Role of Cellular Hypoxia and Bioenergetic Failure in Sepsis.
Concepts in Emergency and Critical Care: Ventilator-Associated Pneumonia: A Multivariate Analysis.