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Septic Shock

What is septic shock?

Sepsis is the result of an infection, and causes drastic changes in the body. It can be very dangerous and potentially life-threatening.

It occurs when chemicals that fight infection by triggering inflammatory reactions are released into the bloodstream.

Doctors have identified three stages of sepsis:

  • Sepsis is when the infection reaches the bloodstream and causes inflammation in the body.
  • Severe sepsis is when the infection is severe enough to affect the function of your organs, such as the heart, brain, and kidneys. 
  • Septic shock is when you experience a significant drop in blood pressure that can lead to respiratory or heart failure, stroke, failure of other organs, and death.

It is thought that the inflammation resulting from sepsis causes tiny blood clots to form. This can block oxygen and nutrients from reaching vital organs.

The inflammation occurs most often in older adults or those with a weakened immune system. But both sepsis and septic shock can happen to anyone.

Septic shock is the most common cause of death in intensive care units in the United States.

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What are the symptoms of septic shock?

Symptoms

Early symptoms of sepsis should not be ignored. These include:

  • fever usually higher than 101˚F (38˚C)
  • low body temperature (hypothermia)
  • fast heart rate
  • rapid breathing, or more than 20 breaths per minute

Severe sepsis is defined as sepsis with evidence of organ damage that usually affects the kidneys, heart, lungs, or brain. Symptoms of severe sepsis include: 

  • noticeably lower amounts of urine
  • acute confusion
  • dizziness
  • severe problems breathing
  • bluish discoloration of the digits or lips (cyanosis)

People who are experiencing septic shock will experience the symptoms of severe sepsis, but they will also have very low blood pressure that doesn’t respond to fluid replacement.

What causes septic shock?

Causes

A bacterial, fungal, or viral infection can cause sepsis. Any of the infections may begin at home or while you are in the hospital for treatment of another condition.

Sepsis commonly originates from:

  • abdominal or digestive system infections
  • lung infections like pneumonia
  • urinary tract infection
  • reproductive system infection

What are the risk factors?

Risk Factors

Certain factors such as age or prior illness can put you at greater risk for developing septic shock. This condition is common in newborns, older adults, pregnant women, and those with suppressed immune systems caused by HIV, rheumatic diseases such as lupus and rheumatoid arthritis, or psoriasis. And inflammatory bowel diseases or cancer treatments could cause it.

The following factors could also make it more likely that a person develops septic shock:

  • major surgery or long-term hospitalization
  • diabetes type 1 and type 2 injection drug use
  • hospitalized patients that are already very sick
  • exposure to devices like intravenous catheters, urinary catheters, or breathing tubes, which can introduce bacteria into the body
  • poor nutrition

Which tests are used to diagnose septic shock?

Diagnosis

If you have symptoms of sepsis, the next step is to conduct tests to determine how far along the infection is. Diagnosis is often made with a blood test. This type of test can determine if any of the following factors are present:

  • bacteria in the blood
  • problems with clotting due to low platelet count
  • excess waste products in the blood
  • abnormal liver or kidney function
  • decreased amount of oxygen
  • electrolyte imbalance

Depending on your symptoms and the results of the blood test, there are other tests that a doctor may want to perform to determine the source of your infection. These include:

  • urine test
  • wound secretion test if you have an open area that looks infected
  • mucus secretion test to see what type of germ is behind the infection
  • spinal fluid test

In cases where the source of the infection is not clear from the tests above, a doctor could also apply the following methods of getting an internal view of your body:

  • X-rays
  • CT scan
  • ultrasound
  • MRI

What complications can septic shock cause?

Complications

Septic shock can cause a variety of very dangerous and life-threatening complications that can be fatal. Possible complications include:

  • heart failure
  • abnormal blood clotting
  • kidney failure
  • respiratory failure
  • stroke
  • liver failure
  • loss of a portion of the bowel
  • loss of portions of the extremities

The complications you may experience, and the outcome of your condition can depend on factors such as:

  • age
  • how soon treatment is started
  • cause and origin of sepsis within the body
  • preexisting medical conditions

How is septic shock treated?

Treatment

The earlier sepsis is diagnosed and treated, the more likely you are to survive. Once sepsis is diagnosed, you will most likely be admitted to an Intensive Care Unit (ICU) for treatment. Doctors use a number of medications to treat septic shock, including:

  • intravenous antibiotics to fight infection
  • vasopressor medications, which are drugs that constrict blood vessels and help increase blood pressure
  • insulin for blood sugar stability
  • corticosteroids

Large amounts of intravenous (IV) fluids will be administered to treat dehydration and help increase blood pressure and blood flow to the organs. A respirator for breathing may also be necessary. Surgery may be performed to remove a source of infection, such as draining a pus-filled abscess or removing infected tissue.

Long-term outlook for septic shock

Outlook

Septic shock is a severe condition, and more than 50 percent of cases will result in death. Your chances of surviving septic shock will depend on the source of the infection, how many organs have been affected, and how soon you receive treatment after you first begin experiencing symptoms.

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