Septic Shock - Definition, Causes, Symptoms and Treatment

Septic shock is a serious medical condition. During septic shock, the body tissues and organs do not get enough blood and oxygen. Septic shock occurs most often in the very old and the very young. It also occurs in people who have other illnesses. Serious bacterial infections at any body site, with or without bacteremia, usually are associated with important changes in the function of every organ system in the body. Septic shock can lead to multiple organ failure including respiratory failure, and may cause rapid death. Toxic shock syndrome is one type of septic shock. Septic shock is usually preceded by bacteremia, which is marked by fever, malaise, chills, and nausea. The first sign of shock is often confusion and decreased consciousness. Bacteremia may be primary (without an identifiable focus of infection) or, more often, secondary (with an intravascular or extravascular focus of infection).

Septic shock occurs more often in neonates, patients > 35 yr, and pregnant women. Septic shock is severe sepsis with organ hypoperfusion and hypotension that are poorly responsive to initial fluid resuscitation. The condition develops as a response to certain microbial molecules which trigger the production and release of cellular mediators, such as tumor necrosis factors. Toxic shock syndrome most often occurs in menstruating women using highly absorbent tampons. It occurs in about 40% of patients with gram-negative bacteremia and in about 20% of patients with Staphylococcus aureus bacteremia. Hyperventilation with respiratory alkalosis occurs early, in part as compensation for lactic acidemia. Serum HCO3 is usually low, and serum and blood lactate increase. One of the major causes of the condition leading to septic shock is infection by gram negative organism. The cell walls contain endotoxins which trigger the release of inflammatory mediators which causes vasodilation and increase in capillary permeability leading to shock.

Septic shock is a medical emergency. Prompt treatment of bacterial infections is helpful. Septic shock is treated initially with a combination of antibiotics and fluid replacement. Treatment primarily consists of antimicrobial chemotherapy, removal of the source of infection, and haemodynamic, respiratory, and metabolic support. Coagulation and hemorrhage may be treated with transfusions of plasma or platelets. Dopamine may be given to increase blood pressure further if necessary. High doses of intravenous antibiotics are given as soon as blood samples have been taken for laboratory cultures. Surgery may be performed to remove any dead tissue, such as gangrenous tissue of the intestine. Despite all efforts, more than 25% of people with septic shock die. Corticosteroid therapy appears beneficial. Treatment is with replacement, rather than pharmacologic, doses. Scrupulous aseptic technique on the part of medical professionals lowers the risk of introducing bacteria into the bloodstream.

Treatment for Septic Shock Tips

1. Antimicrobial chemotherapy, removal of the source of infection, and haemodynamic, respiratory, and metabolic support.

2. Corticosteroids, especially if combined with a mineralocorticoid, can reduce mortality among patients.

3. Activated protein C can reduce mortality in patients with multi-organ failure.

4. Coagulation and hemorrhage may be treated with transfusions of plasma or platelets.

5. Dopamine may be given to increase blood pressure further if necessary.

6. Surgery may be performed to remove any dead tissue, such as gangrenous tissue of the intestine.