Sepsis Nani Zaitun Divisi Tropik Infeksi SMF Ilmu Penyakit Dalam RSU Ulin Banjarmasin.

Presentasi berjudul: "Sepsis Nani Zaitun Divisi Tropik Infeksi SMF Ilmu Penyakit Dalam RSU Ulin Banjarmasin."— Transcript presentasi:

1 Sepsis Nani Zaitun Divisi Tropik Infeksi SMF Ilmu Penyakit Dalam RSU Ulin Banjarmasin

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19 Tatalaksana sepsis

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30 Berapa lama diberikan?

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36 De-eskalasi

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42 Terima kasih

43 Procalcitonin Under normal physiological conditions, active CT is produced and secreted in the C-cells of the thyroid gland after proteolytic cleavage of PCT, meaning, in a healthy individual, that PCT levels in circulation are very low (<.05 ng/mL).thyroid gland Bacterial infections induce a universal increase in the CALC-1 gene expression and a release of PCT (>1 μg/mL) it has become a marker to improve bacterial infections identification and guide antibiotic therapy. Measurement of procalcitonin can be used as a marker of severe sepsis caused by bacteria and generally grades well with the degree of sepsissepsis PCT has the greatest sensitivity (85%) and specificity (91%) for differentiating patients with systemic inflammatory response syndrome (SIRS) from those with sepsis, sensitivityspecificitysystemic inflammatory response syndrome Procalcitonin levels may be useful to distinguish bacterial infections from nonbacterial infections.

44 The level of procalcitonin in the blood stream of healthy individuals is below the limit of detection (0.01 µg/L) of clinical assays The level of procalcitonin rises in a response to a proinflammatory stimulus, especially of bacterial origin.bacterial It is therefore often classed as an acute phase reactant.acute phase reactant In this case, it is produced mainly by the cells of the lung and the intestine It does not rise significantly with viral or non-infectious inflammations. With the derangements that a severe infection with an associated systemic response brings, the blood levels of procalcitonin may rise to 100 µg/L.infection In serum, procalcitonin has a half-life of 25 to 30 hours. Remarkably the high procalcitonin levels produced during infections are not followed by a parallel increase in calcitonin or a decrease in serum calcium levels.

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52 The inhospital mortality approaches 30% despite advances in critical care during the last several decades. To date, the largest reductions in mortality have been associated with early identification of sepsis, initiation of a 3-hour care bundle and rapid administration of broad-spectrum antibiotics

53 Sepsis remains a highly lethal entity resulting in more than 200000 USA deaths per year7 and an in-hospital mortality upward of 30% despite advances in critical care

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55 Diagnostic Summary of Studies Investigating the Therapeutic Advantages of PCT