Sepsis a syndrome?

To continue a debate that I am having on another forum...
How would you classify sepsis? Would you classify it as a syndrome, a disease process, or an inflammatory response?

For a little background, it is on an article from JEMS, a prehospital care site, on how sepsis was responsible for over 350,000 deaths in America a year. Some are saying that sepsis is a syndrome. This is what I said...(direct cut and paste. I didn't feel like typing it again.)

And again, I disagree that sepsis is a syndrome. Syndrome, as defined by Stedman's is the combination of signs and symptoms associated with a particular morbid process, which together constitute the picture of disease or inherited anomaly. I can tell you that the medical textbooks and the nursing texts don't classify sepsis as a syndrome. It is an inflammatory response due to untreated bacterial infections. When bacteria enters the blood stream, it sets off the inflammatory response by the releasing of cytokines, which in turn affect the entire vascular system leading to multi-organ failure and cardiovascular collapse.


Here is a link to the article.http://www.jems.com/article/news/sep...americans-each

The article states that it is an inflammatory response, however I want to know what you think. Last edit by ClearBlueOctoberSky on Dec 13, '11 : Reason: punctuation
A syndrome is a group of symptoms that consistently occur together or a conditions characterized by a set of associated symptoms. http://www.merriam-webster.com/dictionary/syndromeSo, by definition, yes, sepsis is a syndrome.Also, by definition on the Mayo Clinic website, sepsis is inflammation triggered by infection. http://www.mayoclinic.com/health/sepsis/DS01004Sepsis is a complex disease process, in my opinion.

it's a cascade.

Sepsis or septicemia is the condition of bacteria being in the bloodstream.Sudden Inflammatory Response Syndrome is the syndrome that is commonly associated with sepsis, but not always SIRS can be caused by other things too.

sepsis is a serious medical condition that is characterized by a whole-body inflammatory state. also called systemic inflammatory response syndrome or sirs, and the presence of a known or suspected infection. the body may develop this inflammatory response to microbes in the blood, urine, lungs, skin, or other tissues. severe sepsis occurs when sepsis leads to organ dysfunction, hypotension, or insufficient blood flow hypoperfusion to one or more organs causing, lactic acidosis, decreased urine production, or altered mental status. sepsis can lead to septic shock, multiple organ dysfunction syndrome, formerly known as multiple organ failure, and death. organ dysfunction results from sepsis-induced hypotension (< 90 mmhg or a reduction of ≥ 40 mmhg from baseline) and diffuse intravascular coagulation.i found this from the cleveland clinic....sepsis, also known as systemic inflammatory response syndrome (sirs), is a serious medical condition caused by the body's response to an infection.sepsis, also known as systemic inflammatory response syndrome (sirs), is a serious medical condition caused by the body’s response to an infection. sepsis can lead to widespread inflammation and blood clotting. inflammation may result in redness, heat, swelling, pain, and organ dysfunction or failure. blood clotting during sepsis causes reduced blood flow to limbs and vital organs, and can lead to organ failure or gangrene (damage to tissues).bacterial infections are the most common cause of sepsis. sepsis can also be caused by fungal, parasitic, or viral infections. the source of the infection can be any of a number of places throughout the body. common sites and types of infection that can lead to sepsis include:the abdomen—an inflammation of the appendix (appendicitis), bowel problems, infection of the abdominal cavity (peritonitis), and gallbladder or liver infectionsthe central nervous system—inflammation or infections of the brain or the spinal cordthe lungs—infections such as pneumoniathe skin—bacteria can enter skin through wounds or skin inflammations, or through the openings made with intravenous (iv) catheters (tubes inserted into the body to administer or drain fluids). conditions such as cellulitis (inflammation of the skin’s connective tissue) can cause sepsis.the urinary tract (kidneys or bladder)—urinary tract infections are especially likely if the patient has a urinary catheter to drain urinehttp://my.clevelandclinic.org/disord...ic_sepsis.aspxaccording to the american college of chest physicians and the society of critical care medicine,[2] there are different levels of sepsis:systemic inflammatory response syndrome (sirs). defined by the presence of two or more of the following findings:body temperature < 36 �c (97 �f) or > 38 �c (100 �f) (hypothermia or fever).heart rate > 90 beats per minute.respiratory rate > 20 breaths per minute or, on blood gas, a pco2 less than 32 mm hg (4.3 kpa) (tachypnea or hypocapnia due to hyperventilation).white blood cell count < 4,000 cells/mm3 or > 12,000 cells/mm3 (< 4 � 109 or > 12 � 109 cells/l), or greater than 10% band forms (immature white blood cells). (leukopenia, leukocytosis, or bandemia).sepsis. defined as sirs in response to a confirmed infectious process. infection can be suspected or proven (by culture, stain, or polymerase chain reaction (pcr)), or a clinical syndrome pathognomonic for infection. specific evidence for infection includes wbcs in normally sterile fluid (such as urine or cerebrospinal fluid (csf)); evidence of a perforated viscus (free air on abdominal x-ray or ct scan; signs of acute peritonitis); abnormal chest x-ray (cxr) consistent with pneumonia (with focal opacification); or petechiae, purpura, or purpura fulminans.severe sepsis. defined as sepsis with organ dysfunction, hypoperfusion, or hypotension.septic shock. defined as sepsis with refractory arterial hypotension or hypoperfusion abnormalities in spite of adequate fluid resuscitation. signs of systemic hypoperfusion may be either end-organ dysfunction or serum lactate greater than 4 mmol/l. other signs include oliguria and altered mental status. patients are defined as having septic shock if they have sepsis plus hypotension after aggressive fluid resuscitation (typically upwards of 6 liters or 40 ml/kg of crystalloid solution)http://en.wikipedia.org/wiki/sepsissystemic inflammatory response syndrome or sirs is evidence of the body's ongoing inflammatory response. when sirs is suspected or known to be caused by an infection, this is sepsis. severe sepsis occurs when sepsis leads to organ dysfunction, such as trouble breathing, coagulation or other blood abnormalities, decreased urine production, or altered mental status. if the organ dysfunction of severe sepsis is low blood pressure (hypotension), or insufficient blood flow (hypoperfusion) to one or more organs (causing, for example, lactic acidosis), this is septic shock.http://en.wikipedia.org/wiki/systemi...ponse_syndromemaybe not the answer you were looking for but i hope this helps..

Esme, thanks for the information.All replies help. I was just wondering what other people thought. I enjoy the discussion. When I went through Paramedic school, not a whole lot was devoted to patho. Most have been taught "cookbook medicine" as in you have this and this, so you do this and that and go here. My education, we were always taught to think about why we are doing what we are doing and how our patient got to that point in the first place, but still not everyone knows a lot about the WHY. I have always wanted to know and to improve my knowledge base. Going through nursing school, I not only built on what I knew as a Paramedic, but I learned a great deal more. I think we should always learn and adapt or change our thinking to the better. When I received a patient with something I didn't understand, I always tried to talk to the doctors, nurses and then do the research. I still have a great deal to learn.Thanks for the discussion.

We recently had a pt diagnosed with "septic shock syndrome," which sounded odd to me. But Esme's info makes sense.

there is also tss or toxic shock syndrometoxic shock syndrome (tss) is a potentially fatal illness caused by a bacterial toxin. different bacterial toxins may cause toxic shock syndrome, depending on the situation. the causative bacteria include staphylococcus aureus and streptococcus pyogenes. streptococcal tss is sometimes referred to as toxic shock-like syndrome (tsls) or streptococcal toxic shock syndrome (stss).http://en.wikipedia.org/wiki/toxic_shock_syndrometoxic shock syndromedisease listing | general information | technical information | additional information

Quote from ScottESepsis or septicemia is the condition of bacteria being in the bloodstream.Sudden Inflammatory Response Syndrome is the syndrome that is commonly associated with sepsis, but not always SIRS can be caused by other things too.

bah, adminsiter meds as ordered....move on

Quote from czyjaSepis may be septicemia, but not always.

Quote from mindlorbah, adminsiter meds as ordered....move on