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Septic Shock – Symptoms, Causes, Treatment

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What is Septic Shock?

Septic shock is just one of the many other types of lethal conditions. Septic shock, as the name suggests, is primarily due to an ongoing infectious process, either localized or generalized. There are several pathogens that would lead to septic shock including most types of bacteria, some fungi and in rare cases, viruses. This type of shock commonly affects those people with extremes in age, either too young or too old, and those who have compromised immune system whose body cannot effectively deal with the infection. Septic shock develops as a result of poor perfusion to the different parts of the body especially to the vital organs.


During an infectious process, the body tries to ward off the pathogen by activating certain immune responses. A healthy individual with competent immune system would effectively deal with the underlying infection. However, for others who are too young or too old, whose immune system is not as competent, combating the infection instead wreaks havoc. In the attempt to eradicate the pathologic agent, the immune system releases substances that would cause dilation of the vessels. Due to systemic vasodilation, the blood circulating to the different parts of the body is drastically reduced and blood pressure drops alongside. The infectious process still continues however. The mortality rate of septic shock accounts for about 50 per cent of the total cases.

It is imperative that each of us is made aware of this condition because this spares none of us. Septic shock affects nearly all of us. Here are some of the crucial matters that you should learn about septic shock:

Septic Shock Symptoms

The symptoms of septic shock may start to be just very benign without giving you a clue that this would lead into something life threatening. This may also begin as a simple fever accompanied by chills but later on progresses into something severe. Overall, septic shock symptoms may vary from one person to another. However, the common symptoms of septic shock that you should especially note for include the following:

  • Fever – This is considered to be the initial and most common manifestation of an impending septic shock. An elevation in temperature is primarily due to the presence of pathogens in the body.
  • Chills – Chills is a symptom that may likely accompany fever. This is the body’s attempt to eliminate excess body heat.
  • Changes in sensorium – There may also be some changes in the mental functioning of an individual. Disorientation, confusion, apprehension and anxiety are some of the mental changes that may be noted.
  • Hyperventilation – An affected individual may also have difficulty breathing and experience hyperventilation due to untreated respiratory alkalosis. The presence of inflammatory mediators and endotoxins stimulate the medullary respiratory center resulting to hyperventilation.

Septic Shock Causes

The primary cause of septic shock is established to be the presence of bacteria, fungi and certain viruses in the bloodstream. However, about 70 percent of septic shock cases are caused by gram negative bacteria. Individuals who are very young or are very old are usually the ones vulnerable to this type of shock. Immunocompromised individuals such as those who have HIV-AIDS have dramatically higher risks. Another reason for the development of septic shock is the condition called systemic anti-inflammatory response syndrome (SIRS) which leads to multi-organ failure, depressed blood pressure and failure in the pumping mechanism of the heart. The patient would usually die due to the failure in stabilizing the abnormally low blood pressure.

Diagnosis

Septic shock can be diagnosed basing on the symptoms alone. However, there are other tests that would help confirm the presence of this condition and these include:

  • Blood tests/cultures
  • Urinalysis
  • Checking for the acid/base balance- There are usually imbalances in acid and base due to the presence of bacterial toxins.
  • X-ray- The common findings of x-rays would be suggestive of pneumonia and presence of fluid in the lungs (pulmonary edema) may be detected.
  • Other imaging studies such as CT scan, ultrasound and MRI.

Treatment

Early detection and prompt treatment are critical factors in dealing with septic shock. The main goal of treating septic shock is to salvage the patient from a possible hypotension and hypovolemia. The next priority is to treat the underlying infection and of course maintain the normal functioning of the vital organs. The common treatment modalities of septic shock include the following:

Oxygen supplementation

Giving supplemental oxygen to patients with septic shock is necessary to establish good airway. However, for severe cases, mechanical ventilation may be required.

Intravenous infusion

Fluid therapy is also very essential in managing patients suffering from septic shock. About 1-2 liters of crystalloid fluids are initially given to correct underlying hypovolemia. Crystalloid fluid infusion is usually titrated until the body’s normal fluid volume and as well as blood pressure has been established.

Antibiotic therapy

Choosing the right type of antimicrobials plays a critical role in dealing with septic shock. Early identification of the right antibiotic to use would lead to a better prognosis later on. Failure to administer antibiotics at the earlier stages of the condition would oftentimes lead to mortality.

Antipyretics

It is also important to control the temperature because patients suffering from septic shock would likewise suffer from hyperthermia. There are also other physical cooling methods that would help control hyperthermia and these include the use of thermal blankets and as well as sponging.

Correcting Acid-Base Imbalance

Another important thing to consider in septic shock is to correct the underlying acid-base imbalance. Septic shock also has the tendency to cause respiratory alkalosis and metabolic acidosis due to the release of endotoxins.

Nourishment

Most of all, the nutritional requirements of patients with septic shock still have to be met. Nutritional therapy may be given orally, enterally or intravenously.

Prognosis

Prompt medical attention should be given to patients with septic shock because this has a high death rate. There are several factors that would determine the rate of recovery and these include the patient’s general state of health, age and as well as the condition of the immune system.

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