Septic Shock

What is Septic Shock?

Low systemic vascular resistance and an elevated cardiac output characterize septic shock. The disorder is thought to occur in response to infections that release microbes or one of the immune mediators.

Causes of Septic Shock

Septic shock occurs most often in the very old and the very young. It also occurs in people who have other illnesses.

Any type of bacteria can cause septic shock. Fungi and (rarely) viruses may also cause the condition. Toxins released by the bacteria or fungus may cause tissue damage, and may lead to low blood pressure and poor organ function. Many researchers believe that abnormal blood clots in small arteries cause the lack of blood flow and poor organ function.

The toxins also cause a strong inflammatory response from the body, which contributes to septic shock.

Signs & Symptoms of Septic Shock

If you develop a small infection in one part of the body, the symptoms may include redness, swelling, and tenderness. Signs that the infection has spread throughout the body are fever, fast breathing, dizziness, and fast heart rate.

Diagnostic Tests

Diagnosis of septic shock is made by measuring blood pressure, heart rate, and respiration rate, as well as by a consideration of possible sources of infection. Blood pressure may be 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. The levels of oxygen, carbon dioxide, and acidity in the blood are also monitored to assess changes in respiratory function.

Treatment

Location and treatment of the underlying sepsis is essential to treating septic shock. If any I.V., intraarterial. or urinary drainage catheters are in place. they should be removed. Aggressive antimicrobial therapy appropriate for the causative organism must be initiated immediately. Culture and sensitivity tests help determine the most effective antimicrobial drug.

In patients who are immunosuppressed because of drug therapy. drugs should be discontinued or reduced. Granulocyte transfusions may be used in patients with severe neutropenia.

Oxygen therapy should be initiated to maintain arterial oxygen saturation greater than 95%. Mechanical ventilation may be required if respiratory failure occurs.

Colloid or crystalloid infusions are given to increase intravascular volume and raise blood pressure. After sufficient fluid volume has been replaced. diuretics such as furosemide can be given to maintain urine output above 20 ml/hour. If fluid resuscitation fails to increase blood pressure. a vasopressor such as dopamine can be started. Blood transfusion may be needed if anemia is present.

Prevention Tips

Prompt treatment of bacterial infections is helpful. However, many cases of septic shock cannot be prevented.