Septic Shock

Septic shock is what happens as a complication of an infection where toxins can initiate a full-body inflammatory response. It often occurs in people who are elderly or have a weakened immune system.

It is thought that the inflammation resulting from sepsis causes tiny blood clots to form, which can block oxygen and nutrients from reaching vital organs. As a result, the organs fail, causing a profound septic shock. This may cause a drop in blood pressure and may result in death. In fact, septic shock is the most common cause of death in intensive care units in the United States (Fitch, et al., 2002).

Doctors have identified three stages of sepsis:

• sepsis, when an infection reaches the bloodstream and causes inflammation throughout the body
• severe sepsis, which occurs when infection disrupts blood flow to the brain or kidneys, leading to organ failure. Blood clots cause gangrene (tissue death) in the arms, legs, fingers, and toes.
• septic shock, when blood pressure drops significantly. This can lead to respiratory, heart, or organ failure and death.

If you recently had surgery, have been released home, and experience any of the symptoms below, immediate medical treatment may be necessary. The earlier that treatment with antibiotics and intravenous (IV) fluids can be administered, the greater a person’s chance for surviving septic shock.

Symptoms of septic shock require that only one of the following signs be present:

• patches of discolored skin
• noticeably lower amounts of urination
• confusion
• problems breathing
• abnormal heart functions, such as palpitations or rapid heart rate
• chills due to fall in body temperature
• extreme weakness or lightheadedness

Sepsis can be caused by any type of infection: bacterial, fungal, or viral. Bacterial infections often develop while a person is still in the hospital. Sepsis commonly originates from:

• abdominal or digestive system infections
• lung infections like pneumonia, bronchitis, or lower respiratory tract infections, which are responsible for around 25 percent of cases (NHS)
• urinary tract infection
• reproductive system infection

Certain factors such as age or prior illness can put you at greater risk for developing septic shock. This condition is especially prevalent in newborns, older people, pregnant women, and those with suppressed immune systems because of HIV or cancer treatments. In addition, the following factors will also make it more likely that a person develop septic shock:

• major surgery or long-term hospitalization (increased risk of bacteria)
• diabetes
• injection drug use
• ICU patients that are already very sick
• exposure to invasive devices such as intravenous catheters or breathing tubes, which can introduce bacteria into the body

If you have symptoms of sepsis, the next step is to conduct tests to determine how far along the infection is. Diagnosis is often made with a blood test. This type of test can determine if any of the following factors are present:

• bacteria in the blood
• problems with clotting due to low platelet count
• excess waste products in the blood
• abnormal liver or kidney function
• decreased amount of oxygen
• electrolyte imbalance

Depending on your symptoms and the results of the blood test, there are other tests that a doctor may want to perform to determine the source of your infection, including:

• urine test
• wound secretion test (if you have an open area that looks infected)
• mucus secretion test (to see what type of germ is behind the infection)
• brain and spinal fluid test

In cases where the source of the infection is not clear from the tests above, a doctor might want to get an internal view of your body using one of the following:

• X-rays, which allow a doctor to get a good view of the lungs
• computed tomography (CT) scans, which give the doctor a view of possible infections in the appendix, pancreas, or bowel areas
• ultrasound, which allows a doctor to view infections in the gallbladder or ovaries
• magnetic resonance imaging (MRI), which gives doctors a view of any soft tissue infections, such as spinal abscesses

The earlier sepsis is diagnosed and treated, the more likely you are to survive. Once sepsis is diagnosed, you will most likely be admitted to an Intensive Care Unit (ICU) for treatment. Doctors use a number of medications to treat septic shock, including:

• intravenous antibiotics to fight infection
• vaso pressure medications – drugs that constrict blood vessels and help increase blood pressure
• insulin for blood sugar stability
• corticosteroids to help with inflammation

Large amounts of IV fluids will be administered to prevent dehydration and help increase blood pressure. A respirator for breathing may also be necessary. Surgery may be performed to remove a source of infection, such as draining a pus-filled abscess or removing infected tissue.

Septic shock is a severe condition, and more than 50 percent of cases will result in death (NHS). Your chances of surviving septic shock will depend on the source of the infection, how many organs have been affected, and how soon you received treatment after your symptoms began.