Definition: Sepsis-like clinical presentation as patients present with systemic inflammation (SIRS), coagulation activation (DIC) and endothelial disruption.
Clinical signs:
- tachycardia/bradycardia
- tachypnoea
- fever/hypothermia
- hypoperfusion
- multi-organ failure
- bleeding, oedema, etc.
Treatment:
- Haemodynamic optimisation: use of early goal-directed therapy. Our goals will be a central venous pressure of 0-10 cm H2O, MAP 80-120 mmHg, ScvO2 > 70% and lactate < 2.5 mmol/L.
- Glycaemic control: Hyperglycaemia worsens ischaemic brain damage. Regular insulin is recommended to keep glucose below 180 mg/dL.
- Adrenal dysfunction: Critical illness-related corticosteroid insufficiency (CIRCI) has been described in people after PCP. Consider low dose hydrocortisone/methylprednisolone in patients who are vasopressor dependent.
