Septic Shock
Overview
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 to 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.
SymptomsandDiagnosis
Symptoms
Septic shock may cause:
- Fever, which may be followed by a drop in body temperature to below normal
- Warm, flushed skin
- Chills
- Rapid, pounding heartbeat
- Rapid breathing or trouble breathing
- Confusion
- Reduced alertness
- Irregular blood pressure
- Reduced urination
- Severe bleeding— disseminated intravascular coagulation
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:
- Blood tests to assess white blood cell counts and inflammatory markers that might indicate how serious the infection is, as well as oxygen levels and kidney function to assess damage to specific organs.
- Cultures to check for infectious organisms
- ECG to check for heart rhythm irregularities
- Imaging tests may be used to look for specific sources of infection, such as pneumonia
Treatments
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
You will be given high doses of one or more antibiotics or antifungal medications. The medications may be changed once the specific cause of the infection is identified.
Surgery
Surgery may be performed to remove any dead tissue or drain infections.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
Edits to original content made by Denver Health.
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RESOURCES
Centers for Disease Control and Prevention https://www.cdc.gov
Society of Critical Care Medicine http://www.sccm.org
CANADIAN RESOURCES
CAEP—Canadian Association of Emergency Physicians http://www.caep.ca
Health Canada https://www.canada.ca
References
Rhodes A, Evans LE, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2016. Intensive Care Med. 2017;43(3):304-377.
Sepsis and septic shock. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/critical-care-medicine/sepsis-and-septic-shock/sepsis-and-septic-shock. Updated April 2016. Accessed December 15, 2017.
Sepsis. National Institute of General Medical Sciences website. Available at: https://www.nigms.nih.gov/Education/Pages/factsheet%5Fsepsis.aspx. Updated December 11, 2017. Accessed December 15, 2017.
Sepsis in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115805/Sepsis-in-adults . Updated July 28, 2017. Accessed December 15, 2017.
Sepsis treatment in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T316889/Sepsis-treatment-in-adults . Updated November 17, 2017. Accessed December 15, 2017.