Septic shock: causes, signs, diagnosis

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Septic shock is the most severe level of sepsis , a life-threatening medical emergency that occurs when the immune system reacts violently to an existing infection.

When this happens, the immune system releases chemicals into the bloodstream that attack the body's own tissues. Blood pressure drops dangerously low, which can lead to organ failure.

This article looks at the causes and symptoms of septic shock and how it can be diagnosed and treated. It also includes information on when septic shock is most likely to develop and who is most at risk.

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Steps leading to septic shock

The body generally reacts to infection by keeping it where it started. But if the infection cannot be located where it started, it can spread to other parts of the body through the bloodstream.

Most infections that cause sepsis and septic shock are caused by bacteria.

When bacteria from one part of the body enter the bloodstream, it is called bacteremia or septicemia . If not treated quickly, it can turn into sepsis.

In a typical infection, your immune system releases cytokines to dilate blood vessels at the site of infection. This response allows more blood to be sent to the area with infection-fighting white blood cells.

However, in sepsis, cytokines are metabolized and cause massive inflammation throughout the body. This " cytokine storm " damages the heart and its ability to pump blood throughout the body.

Sepsis turns into septic shock, when blood pressure drops as a result. Then the blood stops entering the organs, which can lead to multiple organ failure.

Summary

Sepsis is an infection that spreads through the bloodstream. Septic shock is the most serious sepsis when blood can no longer get where it needs to go. Septic shock is life threatening.

Causes of septic shock

Sepsis can start with almost any type of infection, from minor infections, such as an abscess in an athlete's tooth or foot , to serious infections, such as meningitis , which affects the lining of the brain and spinal cord.

The infection most often begins with one of the following events:

Septic shock can also be a complication of yeast infections like yeast infections or viral infections like influenza or COVID-19 .

You can't pass sepsis to another person, but you can pass infections that can lead to sepsis and septic shock.

It is important to remember that not all infections turn into sepsis. Even fewer cases progress to septic shock.

Infection after surgery

Sepsis and septic shock are more common after surgery for several reasons. First, urinary tract infections are more common after surgery, and these infections can lead to sepsis.

Second, while the incision made during surgery is obviously essential for the surgeon to work, it can also serve as an open door for bacteria and other microorganisms.

Surgery also affects the body and weakens the immune system . Even if the procedure is minor, there is a risk of infection.

Risk factor's

Infection is a major risk factor for septic shock, and anyone can get it. However, the following people are at higher risk:

  • Adults over 65
  • Children under 1 year
  • People who have had sepsis before
  • People with a weakened immune system . They are more likely to get an infection, which increases the risk of sepsis.

Chronic conditions that weaken the immune system and therefore increase the risk of sepsis include:

Summary

Pneumonia, UTIs, and many other infections (even minor ones) can lead to sepsis and septic shock. People who have had surgery, people older than 65, younger than 1 year, or people with weakened immune systems are at particular risk.

Symptoms

70% of people who go into septic shock do not survive. Given how quickly sepsis can worsen, about 40% of patients with septic shock die even after treatment.

Your chances of survival are greatly increased if you seek medical attention within the first six hours of noticing sepsis symptoms, which is why knowing what they are is so important.

Symptoms of sepsis and septic shock can include:

  • Confusion or disorientation
  • Severe pain or discomfort
  • Fever, chills, or feeling very cold.
  • Difficulty breathing
  • Clammy or sweaty skin
  • Fast heart rate

If you have any signs or symptoms of sepsis or septic shock, especially if you have a known infection, seek medical attention immediately.

Likewise, if you recently had surgery, closely monitor your incision for signs of infection , such as pus, redness, or swelling. Go to the hospital right away if you have a fever or painful urination.

While this is rare, it is worth noting that septic shock can affect young, healthy people. It is not uncommon for someone to look perfectly healthy and normal one fine day, and after 48 hours they become seriously ill with septic shock.

Diagnostics

There are physical changes that a doctor can check to diagnose septic shock. This includes:

  • Fever, body temperature greater than 100.4 degrees Fahrenheit
  • Hypothermia , body temperature below 96.8 degrees Fahrenheit.
  • Low blood pressure
  • High heart rate
  • Difficulty breathing

Also, your healthcare provider can perform blood and urine tests to look for signs of infection and determine the type. Certain tests can show if your organs are working properly.

The most important tool for diagnosing sepsis in the early stages is a blood test for procalcitonin (PCT) . PCT is a protein that increases rapidly in the blood as a bacterial infection spreads. Doctors can use a PCT test to see how widespread the infection is.

The PCT test is also important because it tells doctors if antibacterial drugs are appropriate for treatment. While bacterial infections cause high PCT scores, viral and fungal infections cause very low PCT levels.

You may also need imaging tests , such as X- rays or CT scans (computed tomography) , especially if the source of the infection is unclear.

Summary

If you notice signs of sepsis and septic shock, call 911 right away, especially if you've recently had surgery or have a known infection. In the hospital, wait for the doctors to do blood and urine tests.

Watch out

Treatment takes place in a hospital. You may be placed in an intensive care unit (ICU) .

Antibiotics should be prescribed within an hour after arriving at the hospital. Diagnostic tests will be ordered to confirm the infection and its type, but it may take at least 48 hours to get the results. The benefits of immediate treatment far outweigh any risks.

Antibiotics are injected directly into a vein (intravenously) so they enter the bloodstream right away. A 2019 survey on the use of antibiotics for sepsis found that intravenous antibiotics are most often given for seven to ten days.

However, if diagnostic tests show a different type of infection, you may be switched from antibiotics to antifungal, antiviral , or other targeted treatments , if necessary.

Regardless of the type of infection, you will be given intravenous fluids to prevent a drop in blood pressure. You may also be prescribed vasopressors , which constrict your blood vessels and help raise your blood pressure.

If you find it difficult to breathe, you may be placed on a ventilator , also known as a respirator or breathing apparatus.

When surgery may be necessary

After initial antibiotic treatment, surgery to remove tissue or amputate a septic limb may be recommended. Surgery ensures that any damaged tissue is gone and that you are not infected. It also helps maintain maximum mobility.

The idea of even the possible loss of a limb is surprising. It may be helpful to know that only about 1% of sepsis survivors require one or more surgical amputations. This usually occurs within the first 36 hours to 90 days after the onset of sepsis.

Summary

Immediate treatment of sepsis is necessary to prevent or minimize complications, including progression to septic shock. Antibiotics are prescribed before the cause of the infection is confirmed. Fluids and medications are used to maintain blood pressure. In some cases, respiratory assistance and surgery may be required.

Summary

Sepsis occurs when an infection spreads through the bloodstream to multiple areas of the body. This turns into septic shock, when blood pressure drops dangerously low and disrupts organ function.

Septic shock is life threatening. If you notice any signs of sepsis, go to the emergency room right away. You may be placed in an intensive care unit where your blood pressure and breathing will be closely monitored.

The medication you take will depend on the type of infection you have: viral, bacterial, or fungal.

Get the word of drug information

If you or your loved one has experienced septic shock, you may want to join a support group or connect with others who have battled sepsis or any ongoing health problems associated with septic shock.

Resources to help you cope with your recovery are also available through the Sepsis Alliance nationwide.

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