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Septic Shock

Definition

Sepsis is a systemic inflammatory response to a severe infection. The inflammatory response triggers a rapid series of events, such as leaking blood vessels and impaired blood flow.
Severe sepsis is associated with a drop in blood pressure. Low blood pressure reduces the amount of oxygen and nutrients going to the body's organs. This drop causes damage the body's major organs.
Septic shock occurs when adequate blood pressure cannot be restored despite treatment with IV fluids. Septic shock may lead to multiple organ failure and death.

Causes

Septic shock is caused by an infection that overwhelms the body. Sepsis can be triggered by many different kinds of infections including:
Lung sepsis infant
An infection of the lungs has spread throughout the body, leading to septic shock.
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Risk Factors

Septic shock is more common in infants and in people over 50 years old. Other factors that may increase your chance of septic shock include:

Symptoms

Septic shock may cause:
Complications from septic shock may cause symptoms of:

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include the following:

Treatment

Sepsis and septic shock require immediate care. Treatment includes the following:

Supportive Measures for Shock

If you have septic shock, you will be admitted to the intensive care unit. There you will be given:
  • IV fluids
  • Medications to increase blood pressure and blood flow to your organs
  • Extra oxygen
  • Corticosteroids may be needed to reduce the inflammatory response, especially if fluids aren't working
If your lungs fail, you may be put on a mechanical ventilator to help you breathe. Other therapies or supportive measures may be used.

Medications

Once the cause of the infection has been tested for, you will be given high doses of one or more antibiotics or antifungal medications. Once a specific infection is identified, the may be changed.

Surgery

Surgery may be performed to remove any dead tissue or drain infections.

Prevention

Most cases of septic shock cannot be prevented. Treating bacterial and other infections promptly may help.

RESOURCES

Centers for Disease Control and Prevention http://www.cdc.gov

Society of Critical Care Medicine http://www.sccm.org

CANADIAN RESOURCES

Canadian Association of Emergency Physicians http://www.caep.ca

Health Canada http://www.hc-sc.gc.ca

References

Behrman RE, et al. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders; 2007.

Dellinger RP, Levy MM, Rhodes A, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013;41(2):580-637.

Goldman L, Ausiello D, eds. Cecil Textbook of Internal Medicine. 23rd ed. Philadelphia, PA: Saunders; 2008.

Marx JA, et al. Rosen's Emergency Medicine.7th ed. St. Louis, MO: Mosby, Inc.; 2009.

Sepsis and septic shock. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/critical%5Fcare%5Fmedicine/sepsis%5Fand%5Fseptic%5Fshock/sepsis%5Fand%5Fseptic%5Fshock.html. Updated July 2013. Accessed November 6, 2015.

Sepsis fact sheet. National Institute of General Medical Sciences website. Available at: http://www.nigms.nih.gov/Education/Pages/factsheet%5Fsepsis.aspx. Updated August 2014. Accessed November 6, 2015.

Sepsis in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 21, 2015. Accessed November 6, 2015.

Sepsis treatment in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 27, 2015. Accessed November 6, 2015.

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