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Septic shock
Definition
Septic shock is a serious condition that occurs when an overwhelming infection leads to low blood pressure and low blood flow. The brain, heart, kidneys, and liver may not work properly or may fail.
See also:
Alternative Names
Bacteremic shock; Endotoxic shock; Septicemic shock; Warm shock
Causes
Septic shock occurs most often in the very old and the very young. It also occurs in people who have other illnesses.
Any type of bacteria can cause septic shock. Fungi and (rarely) viruses may also cause the condition. Toxins released by the bacteria or fungus may cause tissue damage, and may lead to low blood pressure and poor organ function. Many researchers believe that abnormal blood clots in small arteries cause the lack of blood flow and poor organ function.
The toxins also cause a strong inflammatory response from the body, which contributes to septic shock.
Risk factors for septic shock include:
- Diabetes
- Diseases that weaken the immune system such as AIDS
- Diseases of the genitourinary system, biliary system, or intestinal system
- Leukemia
- Long-term use of antibiotics
- Lymphoma
- Recent infection
- Recent surgery or medical procedure.
Symptoms
- Cool, pale extremities
- High or very low temperature, chills
- Lightheadedness
- Low blood pressure, especially when standing
- Low urine output (due to kidney failure)
- Palpitations
- Rapid heart rate
- Restlessness, agitation, lethargy, or confusion
- Shortness of breath
Exams and Tests
Blood tests may be done to check for infection, low blood oxygen level, disturbances in the body's acid-base balance, or poor organ function or organ failure.
A chest x-ray may show pneumonia or pulmonary edema.
Treatment
Septic shock is a medical emergency. Patients are usually admitted to the intensive care unit of the hospital.
Treatment may include:
- Drugs to treat low blood pressure, infection, or blood clotting
- Fluids by a vein (intravenously)
- Oxygen
- Surgery
- Support for any poorly functioning organs
There are new drugs that act against the hyperinflammatory response seen in septic shock. These may help limit the damage to vital organs.
Hemodynamic monitoring -- the evaluation of the pressures in the heart and lungs -- may be required. This can only be done with specialized equipment and intensive care nursing.
Outlook (Prognosis)
Septic shock has a high death rate. The death rate depends on the cause of the infection, how many organs have failed, and how quickly and aggressively medical therapy is started.
Possible Complications
Respiratory failure, cardiac failure, or any other organ failure can occur.
When to Contact a Medical Professional
Go directly to an emergency department if you or a loved one have symptoms of septic shock
Prevention
Prompt treatment of bacterial infections is helpful. However, many cases of septic shock cannot be prevented.
Marx J. Rosen's Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002:1957.
Rakel P, ed. Conn's Current Therapy 2005. 57th ed. Philadelphia, Pa: WB Saunders; 2005:71.
Dellinger RP, Carlet JM, Masur H, et al. Surviving Sepsis: Campaign guidelines for management of severe sepsis and septic shock. Crit Care Med. 2004;32:858-873.
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