Septic shock is defined as shock caused by bacterial toxins in blood as a result of infection and causing dramatic drop in blood pressure and preventing the delivery of blood to the organs. Toxic shock syndrome is common type of septic shock.
- Septic shock occurs most often in old and in very young ones. It occurs in people who have other illnesses.
- Any type of bacteria will cause septic shock. Fungi and (rarely) viruses are also cause the condition. Toxins released by bacteria or fungi will cause tissue damage which leads to low blood pressure and poor organ function.
- Some researchers think that blood clots in small arteries will cause lack of blood flow and poor organ function.
- Septic shock often occurs in patients hospitalized for primary infection of genitourinary, biliary, GI and gynecological tracts. Other predisposing factors include immunodeficiency, advanced age, trauma, burns, diabetes mellitus, cirrhosis and disseminated cancer.
- The body also produces a strong inflammatory response to the toxins and contribute to organ damage.
Septic shock will effect any part of the body, including heart, brain, kidneys, liver and intestines.
Common Symptoms include:
- Cool, pale extremities
- High or very low temperature, chills, nausea, vomiting, diarrhea
- Low blood pressure, specially when standing(Hypotension)
- Low urination(Oliguria)
- Rapid heart rate(Tachycardia)
- Restlessness, agitation, lethargy and confusion, altered consciousness.
- Shortness of breath
- Skin rash or discoloration
- Diagnosis of septic shock is done by measuring the blood pressure, heart rate and respiration rate, as well as the consideration of other sources of infection.
- Blood pressure is monitored with a catheter device inserted into the pulmonary artery supplying the lungs (Swan-Ganz catheter).
- Blood cultures are done to determine the type of bacteria responsible for septic shock.
- The levels of oxygen, carbon dioxide and acidity in blood are also monitored to assess changes in respiratory function.( Arterial blood gas analysis)
- A chest x-ray will show pneumonia or fluid in the lungs (pulmonary edema).
- A urine sample will show about any infection.
- Liver function tests, Coagulation studies, Blood cultures, ECG etc.
Sepsis and septic shock are medical emergencies and are treated immediately.
If sepsis is likely then person is admitted to an intensive care unit (ICU) to receive urgent treatment and progress is carefully monitored.
- Oxygen therapy: To breathe more easily, oxygen is given through:
- a face mask,
- a tube inserted into the nose
- an endotracheal (ETT) tube that is inserted into the mouth.
- If there is severe shortness of breath, a mechanical ventilator is used.
- Increasing blood flow: In septic shock fluids are given intravenously (directly into a vein). This will help to increase blood pressure by increasing the amount of fluid in the blood. To increase the blood flow to vital organs, such as brain, liver, kidneys and heart doctors prescribe a type of medication known as a vasopressor like dopamine or norepinephrine. These medicines will cause blood vessels to narrow and increase blood pressure and the flow of blood around the body. This will allow vital organs to start functioning properly.
- Antibiotics: Antibiotics are used to treat sepsis and septic shock. To increase the chances of survival, antibiotics are started before a diagnosis has been confirmed. The antibiotics that are effective in treating the infection will depend up on the type of infection caused by bacteria, and in the location of the infection. Initially, two or three types of antibiotics are used. After the diagnosis is confirmed, and the bacteria responsible for the infection is identified, the most effective type of antibiotic is used.
- Drotrecogin alfa: In severe sepsis or septic shock doctor prescribe a type of medication called drotrecogin alfa (activated protein C) is an artificially produced human protein that will help to prevent inflammation and blood clotting and reducing the risk of death.
- Surgery: In serious cases of sepsis or septic shock, the more decrease in blood pressure and blood flow will cause organ tissue to die (necrosis). If this happens, surgery is required to remove the dead tissue.
Septic shock has a high death rate. The death rate depends on the patient’s age and overall health as the cause of infection, failure of organs and how quickly and aggressively medical therapy is started.
Prompt treatment for bacterial infections is helpful. In many cases of septic shock cannot be prevented.
- Disseminated Intravascular coagulation
- Acute Respiration Distress Syndrome
- Renal failure
- Heart failure
- GI ulcers
- Abdominal hepatic function.