focus on sirs and mods n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Focus on SIRS and MODS PowerPoint Presentation
Download Presentation
Focus on SIRS and MODS

Loading in 2 Seconds...

play fullscreen
1 / 24

Focus on SIRS and MODS - PowerPoint PPT Presentation


  • 747 Views
  • Uploaded on

Focus on SIRS and MODS. (Relates to Chapter 67, “Nursing Management: Shock, Systemic Inflammatory Response Syndrome, and Multiple Organ Dysfunction Syndrome,” in the textbook). SIRS. Systemic inflammatory response syndrome (SIRS) is a systemic inflammatory response to a variety of insults

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Focus on SIRS and MODS' - Thomas


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
focus on sirs and mods

Focus onSIRS and MODS

(Relates to Chapter 67, “Nursing Management: Shock, Systemic Inflammatory Response Syndrome, and Multiple Organ Dysfunction Syndrome,” in the textbook)

slide2
SIRS
  • Systemic inflammatory response syndrome (SIRS) is a systemic inflammatory response to a variety of insults
  • Generalized inflammation in organs remote from the initial insult
slide3
SIRS
  • Triggers
    • Mechanical tissue trauma: burns, crush injuries, surgical procedures
    • Abscess formation: intra-abdominal, extremities
    • Ischemic or necrotic tissue: pancreatitis, vascular disease, myocardial infarction
slide4
SIRS
  • Triggers
    • Microbial invasion: Bacteria, viruses, fungi
    • Endotoxin release: Gram-negative bacteria
    • Global perfusion deficits: Post–cardiac resuscitation, shock states
    • Regional perfusion deficits: Distal perfusion deficits
slide5
MODS
  • Multiple organ dysfunction syndrome (MODS) is the failure of two or more organ systems
    • Homeostasis cannot be maintained without intervention
    • Results from SIRS
slide6
MODS
  • SIRS and MODS represent the ends of a continuum
  • Transition from SIRS to MODS does not occur in a clear-cut manner
sirs and mods
SIRS and MODS
  • Consequences of inflammatory response
    • Release of mediators
    • Direct damage to the endothelium
    • Hypermetabolism
    • Vasodilation leading to decreased SVR
    • Increase in vascular permeability
    • Activation of coagulation cascade
sirs and mods pathophysiology
SIRS and MODSPathophysiology
  • Organ and metabolic dysfunction
    • Hypotension
    • Decreased perfusion
    • Formation of microemboli
    • Redistribution or shunting of blood
sirs and mods pathophysiology1
SIRS and MODSPathophysiology
  • Respiratory system
    • Alveolar edema
    • Decrease in surfactant
    • Increase in shunt
    • V/Q mismatch
    • End result: ARDS
sirs and mods pathophysiology2
SIRS and MODSPathophysiology
  • Cardiovascular system
    • Myocardial depression and massive vasodilation
sirs and mods pathophysiology3
SIRS and MODSPathophysiology
  • Neurologic system
    • Mental status changes due to hypoxemia, inflammatory mediators, or impaired perfusion
    • Often early sign of MODS
sirs and mods pathophysiology4
SIRS and MODSPathophysiology
  • Renal system
    • Acute renal failure
      • Hypoperfusion
      • Release of mediators
      • Activation of renin–angiotensin– aldosterone system
      • Nephrotoxic drugs, especially antibiotics
sirs and mods pathophysiology5
SIRS and MODSPathophysiology
  • GI system
    • Motility decreased: Abdominal distention and paralytic ileus
    • Decreased perfusion: Risk for ulceration and GI bleeding
    • Potential for bacterial translocation
sirs and mods pathophysiology6
SIRS and MODSPathophysiology
  • Hypermetabolic state
    • Hyperglycemia–hypoglycemia
    • Insulin resistance
    • Catabolic state
    • Liver dysfunction
    • Lactic acidosis
sirs and mods pathophysiology7
SIRS and MODSPathophysiology
  • Hematologic system
    • DIC
  • Electrolyte imbalances
  • Metabolic acidosis
sirs and mods collaborative care
SIRS and MODSCollaborative Care
  • Prognosis for MODS is poor
  • Goal: Prevent the progression of SIRS to MODS
  • Vigilant assessment and ongoing monitoring to detect early signs of deterioration or organ dysfunction is critical
sirs and mods collaborative care1
SIRS and MODSCollaborative Care
  • Prevention and treatment of infection
    • Aggressive infection control strategies to decrease risk for nosocomial infections
    • Once an infection is suspected, institute interventions to control the source
sirs and mods collaborative care2
SIRS and MODSCollaborative Care
  • Maintenance of tissue oxygenation
    • Decrease O2 demand
      • Sedation
      • Mechanical ventilation
      • Paralysis
      • Analgesia
sirs and mods collaborative care3
SIRS and MODSCollaborative Care
  • Maintenance of tissue oxygenation
    • Optimize O2 delivery
      • Maintain normal hemoglobin level
      • Maintain normal PaO2
        • Individualize tidal volumes with PEEP
sirs and mods collaborative care4
SIRS and MODSCollaborative Care
  • Maintenance of tissue oxygenation
    • Enhance CO
        • Increase preload or myocardial contractility
        • Reduce afterload
sirs and mods collaborative care5
SIRS and MODSCollaborative Care
  • Nutritional and metabolic needs
    • Goal of nutritional support: Preserve organ function
    • Total energy expenditure is often increased 1.5 to 2.0 times
sirs and mods collaborative care6
SIRS and MODSCollaborative Care
  • Nutritional and metabolic needs
    • Use of the enteral route is preferred to parenteral nutrition
    • Monitor plasma transferrin and prealbumin levels to assess hepatic protein synthesis
sirs and mods collaborative care7
SIRS and MODSCollaborative Care
  • Support of failing organs
    • ARDS: Aggressive O2 therapy and mechanical ventilation
    • DIC: Appropriate blood products
    • Renal failure: Continuous renal replacement therapy or dialysis