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diagnosis anesthesia anesthesiology causes classification criticalcare intraoperative lactate workup lactic overview sepsis anaesthetic cardiacarrest elevation encephalopathy hyperpnea local map neurology
Systemic Inflammatory Response Syndrome (SIRS) • Non-specific (infections vs non-infectious) • ≥2 of the following: o Temp >38°C or <36°C o HR >90 bpm o RR
vs non-infectious ... Septic Shock • ... >2 mmol/L Management ... control (drain abscesses ... #sirs #shock #lactate
Lactic Acidosis - Differential Diagnosis Framework Type A: Impaired O2 Delivery (DO2) • Decreased O2 Delivery: Hypotension
- Differential Diagnosis ... Cardiogenic & Septic Shock ... Localized soft-tissue infection ... Malaria, Late Sepsis ... #Differential #
Tachypnea - Differential Diagnosis Framework Definitions • Tachypnea: Respiratory rate > 20/min, shallow breathing in adults •
Tachypnea - Differential ... • Metabolic acidosis ... • Hypovolemic shock ... dysfunction; toxic ingestions ... exposures • Lactic acidosis
Shock Overview A state of tissue hypoxia due to decreased or dysregulated oxygen delivery or extraction, resulting
Renal: metabolic acidosis ... Inflammatory: infectious ... (sepsis) or not ... Classification #diagnosis #management ... #criticalcare #differential
Shock Overview A state of tissue hypoxia due to decreased or dysregulated oxygen delivery or extraction, resulting
Renal: metabolic acidosis ... Inflammatory: infectious ... (sepsis) or not ... Classification #diagnosis #management ... #criticalcare #differential
Intraoperative Sepsis - Guidelines for Crises in Anaesthesia Severe sepsis (hypotension persisting after initial fluid challenge of
≥ 4mmol.l-1 if infection ... cause) or septic shock ... Discuss ongoing management ... Intraoperative #Checklist ... #Diagnosis #Management
Causes of Lactate Elevation, Lactic Acidosis - Differential Diagnosis The most common causes of hyperlactatemia are usually:
- Differential ... /hypoxemia/Sepsis ... assessment - assess ... syndrome - Sepsis ... #Elevation #Differential
Local Anaesthetic Toxicity - Guidelines for Crises in Anaesthesia Signs of severe toxicity: • Sudden alteration in
after an initial injection ... may help reduce acidosis ... establish intravenous access ... Intraoperative #Checklist ... #Diagnosis #Management
Cardiac Arrest - Guidelines for Crises in Anaesthesia The probable cause is one or more of: something
• If i.v. access ... toxicity (→ 3-10) Acidosis ... CardiacArrest #Checklist ... #Differential # ... #Diagnosis #Management
Posterior Reversible Encephalopathy Syndrome (PRES) Overview Clinico-Radiological Syndrome, characterized by: • Headache • Seizures • Altered mental
Preeclampsia, Eclampsia, Infection ... /Sepsis/Shock, Autoimmune ... Reversible course Differential ... Diagnosis: • Infection ... Syndrome #diagnosis #management
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