What Is Septic ShockK?
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 organ-system 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. Full-blown septic shock is fatal in over two-thirds of cases despite modern therapeutic measures.
What Causes Septic Shock?
- 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.
Symptoms of Septic Shock
- Sudden high fever and chills
- Rapid, shallow breathing (hyperventilation)
- Changes in consciousness or mental state, such as confusion, agitation, disorientation or coma
- Severe fatigue and weakness
- Nausea and vomiting
- Decreased urine output
- Rapid heartbeat
- Thirst from the decrease cerebral tissue perfusion, tachycardia and tachypnea
Septic Shock Prevention
- Obtain prompt treatment for bacterial infections, wounds or burns.
Diagnosis of Septic Shock
- 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.
- Electrocardiogram (ECG) checks the rhythm irregularities of the heart.
How to Treat Septic Shock
- 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.
Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference
Simeon Margolis, M.D., Ph.D., Medical Editor
Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50
Updated by Remedy Health Media