1. Michael Baram Medical Critical Care

3. SevereSepsis Relationship Between SIRS, Sepsis and Severe Sepsis Bone RC, et al. Chest 1992;101:1644-55. Vincent JL. Crit Care Med 1997;25:372-4. Trauma Infection Sepsis Other Pancreatitis Burns SIRS

5. Wall street journal

6. Surviving Sepsis Bundles Sepsis Resusciation Bundle ① ② ③ ④ ⑤ ⑥ ⑦ ① Management Bundle ①. ② ③. ④ ⑤ ⑥ VentilatorBundle ① ② ③ ④ ⑤.

7. Surviving Sepsis Bundles Sepsis Resusciation Bundle  Lactate.  Early Cultures.  Appropriate Abx.  Source Control.  Volume Expansion Cvp 8-12.  Pressors MAP >65.  Inotropes SCVO2 > 70. (t/c blood). Management Bundle  Glycemic Control.  Activated Protein C.  Stress Steroids.  Limit Blood Products.  Limit Vent Stretch.  Limit Bicarb. pH<7.15. VentilatorBundle ①Head of bed. ②Oral Care. ③Sedation Holiday. ④Peptic Ulcer. ⑤DVT Proph.

8. Surviving Sepsis Bundles Sepsis Resusciation Bundle ①Lactate. ②Early Cultures ③Appropriate Abx ④Source Control ⑤Volume Expansion Cvp 8-12 ⑥Pressors MAP >65 ⑦Inotropes SCVO2 > 70 (t/c blood) Management Bundle ①Glycemic Control. ②Activated Protein C ③Stress Steroids. ④Limit Blood Products ⑤Limit Vent Stretch ⑥Limit Bicarb pH<7.15 VentilatorBundle ①Head of bed ②Oral Care ③Sedation Holiday ④Peptic Ulcer ⑤DVT Proph.

9. Guidelines.pdf

10. Lactate- Predictor of Mortality Ann Emergency Med. 2005;45:524-528 1200 consecutive patients presenting with sepsis Ann Emergency Med. 2005;45:524-528 1200 consecutive patients presenting with sepsis

11. Early Appropriate ABX Kumar et al, Critical Care 2006 Jun 34 (6) 1589-96

12. Contr ol Treat ment RR (95% C.I.) P- value In-hospital 46.530.50.58 0.009 28-day Mortality 49.233.30.58 0.01 60-day Mortality 56.944.30.67 0.03

13. CVP failed to Predict: volume status

14. Wrong Vent Setting normal lung 5 minutes (peak press 45) 20 min (peak 45) Dreyfuss Am. J. Respir. Crit. Care Med., Volume 157, Number 1, January 1998, 294-323