Sepsis is a response to infection. In some cases, the body has an extreme reaction to the chemicals released into the bloodstream to fight invaders, and the changes that occur cause multi-system organ damage. When sepsis progresses to this point, it is called septic shock. This medical emergency can lead to death if not treated promptly.
The most common cause of septic shock is a hospital-acquired infection. Immunocompromised patients, the elderly, and those with chronic illnesses are more at risk. Septic shock can also occur after surgery if the surgical site becomes infected. Toxic shock is an uncommon form of septic shock caused by staph and strep infections.
Predisposing risk factors for septic shock include diseases of the intestinal, biliary, respiratory, or urinary systems and those that weaken the immune system. Leukemia, lymphoma, and a history of organ or bone marrow transplant also increase one's risk. Sepsis can quickly advance to septic shock in newborn babies, pregnant women, and the elderly.
Some people are at greater risk of septic shock than others, but because infection causes it, it can happen to anyone. This is why infections, particularly in hospitalized patients, must be closely monitored. Extended use of indwelling catheters, long-term use of antibiotics, and recent surgery, infection, or steroid use can all lead to septic shock, regardless of pre-existing factors.
Septic shock results in a sudden and sharp decrease in blood pressure, which affects the brain, heart, liver, kidneys, intestines, and other systems. Symptoms include fever, chills, low blood pressure when standing, pale extremities, little or no urine output, elevated heart rate, lethargy, palpitations, confusion, restlessness, skin rashes, and decreased cognition.
Doctors confirm diagnoses of septic shock with multiple blood tests, including blood chemistry, blood count, low oxygen level, and acid-base disturbances. Blood culture results reveal the bacteria causing the infection but may take a few days to return a positive result. Other tests include chest x-rays to evaluate the lungs for pneumonia and urine samples to detect infection.
Immediate treatment is key: the predominant goal is to treat sepsis in time to avoid septic shock altogether. The initial treatment is broad-spectrum antibiotics to fight the infection until blood cultures reveal the specific organism responsible. The first six hours are the most important to a good prognosis. Septic shock incidence is halved with prompt and appropriate antibiotic use, regardless of the underlying disease.
Once a patient progresses from sepsis to septic shock, the main treatment goal is to increase blood volume to maintain blood pressure. This ensures adequate tissue and organ perfusion throughout the body. Interventions include the rapid administration of IV fluids and vasoactive drugs to improve cardiac contraction and output. Corticosteroids and blood transfusions may also improve outcomes in some cases.
In addition to increasing blood volume and maintaining perfusion, patients in septic shock require medical support of other organ systems. Many people need intubation and mechanical ventilation to help them breathe. Metabolic support is also necessary to meet nutritional needs and maintain proper electrolyte balance.
Prognosis heavily depends on how quickly the medical team initiates treatment. Today, septic shock mortality is between 30 and 40 percent. Poorer outcomes occur when treatment is not immediate and aggressive. If multi-system organ failure develops or if metabolic processes like lactic or metabolic acidosis are not well controlled, reversing septic shock is exceptionally difficult and often results in fatalities.
In some cases, it is impossible to avoid septic shock. The best prevention is the prompt and effective treatment of bacterial infections. Anyone showing signs of sepsis or septic shock should seek emergency treatment right away.
Even recovered individuals face possible complications. The organs can be permanently damaged, and gangrene may occur if fluids are not adequately administered to extremities.
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