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• Severe sepsis and Septic Shock • • • • • Anaphylactic shock Hypovolemic shock Cardiogenic shock Neurogenic shock Septic Shock • Bacteremia – bacteria in blood • Septicemia – bacteremia with symptoms • Systemic inflammatory response syndrome (SIRS) - fever (>38C) or hypothermia (<36C) - tachypnea (>24 breaths/min) - tachycardia (HR of >90/min) - leukocytosis (>12 000/ul) - leukopenia (<4000/ul) or >10% bands • Sepsis – SIRS that has a proven or suspected mirobial etiology - Elevation of procalcitoin: marker for progression to severe sepsis • Septic Shock – Sepsis + hypotension • Multiple organ dysfunction syndrome (MODS) – dysfunction of more than one organ, as a complication of sepsis. • Chronic disease (Diabetes Mellitus, Chronic renal failure, Chronic Liver failure) • Immunodeficient people (HIV, AIDS, SCID, transplant recipient, autoimmune diseases) • Elderly • Trauma (open wounds) • Hospital acquired (IV-catheters, surgical wounds) 1. Hemodynamic management • Maintain BP and vital organ perfusion and function. 2. Eradicate the infection • Apropriate antimicrobial therapy 3. Inhibition of action of inflammatory mediators.