Sepsis vs Septicemia
These two terms are very technical. They also sound the same and thus are difficult to differentiate. These terms rarely come up in normal conversation unless you are a heath care professional. These terms were used loosely to refer to the presence of multiplying bacteria in the blood stream. But things are different now.
Sepsis is defined assystemic inflammatory response syndromein the presence of infection. Systemic inflammatory response syndrome is a condition defined to highlight the body response to invading organisms. The immune system detects foreign components in the blood stream and releases a wide range of chemicals called cytokines. These cytokines (especially interleukin -1) act on the temperature regulation center of the midbrain and alter the core body temperature. The activation of brainstem centers raises the heart rate and respiratory rate. This leads to hyperventilation, and carbon dioxide gets cleared out of the blood; thus, carbon dioxide partial pressure falls. Cytokines (especially Interleukin 1, 3 and 6), act on bone marrow and increase the white cell production. In some cases, immature white cells get released into the circulation.
Diagnostic criteria for systemic inflammatory response syndrome are as follows.
- 温度超过38摄氏度或低于36 c
- Heart rate above 90 beats per minute
- Respiratory rate above 20 breaths per minute or carbon dioxide partial pressure below 4.3 KPa
- 在12 x 10以上的白细胞9或低于4 x 109or >10% immature forms
Severe sepsisis a condition where there is evidence of poor blood supply to organs. Poor blood supply to the brain will cause confusion, dizziness, lethargy, poor balance, fits, and reduced consciousness level. Poor blood supply to lungs will diminish gas exchange at alveoli, and the oxygen partial pressure will fall. Kidneys need a good blood supply, and in healthy males it is almost 60% of the total cardiac output. So a reduction of blood supply to the kidneys will reduce the filtration at glomeruli and reduce urine production. Cramps and lactic acidosis are signs of poor perfusion of muscles.
Septic shockis a medical emergency where there is a drop of systolic blood pressure below 90 mmHg in the presence of severe sepsis. This needs intramuscular adrenaline injections and intravenous antibiotics. Any patient presenting with a fever needs full blood count, blood urea, serum electrolytes and blood culture. QHT, input output chart, pulse rate chart, blood pressure chart, analgesics, antibiotics, anti-inflammatory drugs may be used as needed according to the clinical condition of the patient. SIRS, sepsis and septic shock are clinical definitions. They represent the need to intensive care or lack of need of same.
Septicemia used to mean the presence of multiplying bacteria in the blood stream. However,it doesn’t give any idea of the clinical condition of the patient.菌血症is a term which means the same and does not give any idea about the clinical condition of the patient. Therefore, bacteremia is in use still while other better terms have replaced the term septicemia.
Septicemia vs Sepsis
• Septicemia suggests the presence of multiplying bacteria in blood while sepsis gives an idea of the clinical condition, in addition to suggesting the presence of bacteria in the blood.
• Septicemia is an obsolete term while sepsis is current.