Thread subject: NEPI :: SEPSIS

Posted by morpheus on 05-09-2008 10:10
#3

oh yes maroju i absolutely do.. and i meant to do that..
since most of the time
sepsis for us in ED as per definition is
SIRS + suspected or proven infection = Sepsis
And like you said there is a problem.
if i have a cough... well with sputum production, i am suspected to have a lower respiratory infection. My sputum culture will be reported after 48 hrs... so no way to confirm an infection.... and i have early mycoplasma pneumonia so my xray is relatively clear.
now i have a fever of a 102 F and i run a mile before i reach the hospital, ( just to trick the doctors)
now i am not very healthy so i obviously have a high heart rate and a high respiratory rate....
so i land up in sepsis... and have all the necessaryl EGDT goals to be fulfilled.
i know about the CRP and the procalcitonin things...
CRP hmmm not much experience in adults i should say... in children... its high even if they have loose stools sometimes...
procalcitonin my personal experience has been mixed...
people with a normal lactate sometimes have a higher procalcitonin...
and vice versa...
i do understand that procalcitonin is supposedly the magic bullet marker...
but then you get its result only after about 2 hours in most places....
so is it valid as a marker of detection?????
or should it be kept as a marker of prognosis and confirmation, as it is treated today!!!
isnt there any other clinical index that can be added to the SIRS criteria to make it better for understanding sepsis????