Septic Shock
What is it?
Septic shock, a life-threatening medical emergency, is the result of an invasion of the bloodstream by infectious agents (septicemia), usually bacteria. In an inflammatory response to the infectious organisms or their toxic products, substances are released that cause blood vessels to dilate, cardiac output to decline, and fluids to leak from small blood vessels into the tissues. Blood pressure then drops precipitously (septic shock), starving the body's cells of oxygen-carrying blood. Cells begin to die. Cell damage can rapidly lead to multiple organsystem failure of the liver, lungs, brain, kidneys, and heart. Failure of any of the vital organs can be fatal. Septic shock occurs most commonly among hospitalized patients, especially those with severe infections. Early recognition of the signs leading up to shock and immediate treatment are imperative. Fullblown septic shock is fatal in over two-thirds of cases despite modern therapeutic measures.
What Causes It?
- A bacterial infection is the most common cause of septic shock. Puncture wounds, deep cuts, burns, surgical procedures, or the use of a urinary catheter can introduce bacteria into the bloodstream.
- Rarely, viral or fungal infections cause septic shock.
- Risk factors for developing septic shock and for suffering more severe consequences include other disorders, such as diabetes mellitus, advanced cancer, and cirrhosis of the liver; severe injury or burns; major surgeries; and a weakened immune system due to AIDS or treatment for cancer, for example. Newborns and the elderly are also at higher risk.
Prevention
- Obtain prompt treatment for bacterial infections, wounds, or burns.
Diagnosis
- Diagnosis may be presumed immediately upon physical examination, patient history, and observation of characteristic symptoms. Because septic shock is an emergency, treatment is initiated prior to laboratory confirmation of diagnosis.
- Blood cultures often provide a definitive diagnosis.
- Radiographic studies frequently point to the cause of septic shock, such as pneumonia or abscess.
How to Treat It
- Hospitalization in an intensive care unit is necessary.
- Intravenous antibiotics are administered to treat a bacterial infection.
- Intravenous fluids and blood transfusions are given to restore adequate fluid volume in the circulatory system and to counteract severe anemia, if present.
- If administration of fluids fails to restore blood pressure to acceptable levels, a vasopressor (blood vessel constricting) drug such as epinephrine or dopamine may be given to increase blood pressure.
- In some cases, drotrecogen, a monoclonal antibody directed against the inflammatory process, may be infused in patients at high risk of death.
- Mechanical respiration through a mask or nasal tubes may be required to supply adequate oxygen.
- Surgery to drain or remove infected tissue or to cleanse a wound of foreign material is performed as needed.
When to Call a Doctor
- EMERGENCY Call an ambulance immediately if someone begins to hyperventilate and is confused and disoriented, with or without fever or nausea.
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Copyright © 2008 Medletter Associates, LLC
Content excerpted from Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference.