Septic Shock

Symptoms of septic shock include fever, nausea, vomiting, and kidney failure.

• Septic shock is persistent hypotension that results from an infection and requires vasopressors (medications that elevate the blood pressure) to maintain a mean arterial pressure of 65 mm Hg or higher and a serum lactate level >2 mmol/L (18 mg/dl) despite adequate volume resuscitation.
• The major causes of septic shock are severe bacterial infections.
• Risk factors include many underlying medical problems that may interfere with the immune system.
• Signs and symptoms of septic shock may include the following:
  • Fever (usually >101 F or 38 C)
  • Chills and/or rigors
  • Fatigue
  • Nausea and/or vomiting
  • Difficulty breathing
  • Cyanosis in fingers and/or lips (bluish/gray color)
  • Anxiety
  • Confusion
  • Low or no urine output (kidney failure)
• If the patient requires vasopressors to maintain a mean arterial pressure of 65 mm Hg or higher and has a serum lactate level >2 mmol/L (18 mg/dl) despite adequate volume resuscitation, then the diagnosis is septic shock.
• Treatment of septic shock usually requires vasopressors, antibiotics, and in some patients, cardiac and/or respiratory support.
• There are three stages of sepsis: sepsis, severe sepsis, and septic shock.
• Complications include heart and/or respiratory failure, kidney failure, abnormal blood clotting, and death.
• The average survival rate is about 71.6%. The prognosis of septic shock ranges from good to poor.
• Reduce the risk for septic shock by treating underlying problems that harm the immune system, aggressively treating sepsis, cleaning and medicating open wounds, and getting vaccinations.

Septic shock (or septic shock syndrome) is low blood pressure that requires vasopressors to maintain a mean arterial pressure of 65 mm Hg or higher and a serum lactate level >2 mmol/L (18 mg/dl) despite adequate volume resuscitation. This is the new 2016 definition, also termed Sepsis-3.

Septic Shock vs. Sepsis

Septic shock is a subset or stage of sepsis, which is life-threatening organ dysfunction due to a dysregulated host response to infection (for example, medical problems that interfere with your immune response to infections like diabetes or cancer).

Both gram-positive and gram-negative bacteria are the major causes of both sepsis and septic shock. Risk factors include genetic diseases, chronic diseases like those in the liver or kidneys, diabetes, immune system problems and being elderly or very young (>70 - <10). Individuals with burns or indwelling devices like catheters have an increased risk as do individuals treated previously with antibiotics or have undergone surgery.

Signs and symptoms of septic shock are not specific and may include one or more of the following:

• Fever (usually >101 F or 38 C)
• Chills and/or rigors
• Fatigue
• Nausea and/or vomiting
• Difficulty breathing
• Cyanosis in fingers and/or lips (bluish/gray color)
• Anxiety
• Confusion
• Low or no urine output (kidney failure)

The elderly may not show some signs and symptoms.

If the patient has persisting hypotension requiring vasopressors to maintain a mean arterial pressure of 65 mm Hg or higher and has a serum lactate level >2 mmol/L, the diagnosis is septic shock. Medical professionals will perform other tests to determine underlying risk factors (for example, chest X-ray to help diagnose pneumonia) and blood cultures to determine the infecting organism. Ultrasound, CT, MRI, and/or lumbar puncture can detect underlying sources of infection.

The management and treatment for septic shock involves hypotension remission, treatment (antibiotics) of infection, locating its source, and when needed, resuscitation to support cardiac and respiratory functions. Hospital admission is required. Medical professionals may administer oxygen delivery, corticosteroids, and other treatments as needed.

There are no stages of septic shock, but sepsis has three stages: sepsis, severe sepsis, and septic shock. Septic shock is the most severe type of sepsis.

Major complications of septic shock are heart failure, respiratory failure, kidney failure, abnormal blood clotting, and death.

The mortality rate or death rate ranges from about 10% in children to 38.4% in the elderly. The average survival rate is about 71.6%. The prognosis ranges widely from good to poor, depending on the patient's response to treatment and the development of complications.

You can decrease your risk of developing septic shock by making sure, during recovery, you follow up and treat any underlying cause that can increase susceptibility to infections (for example, keep diabetes under control). Aggressively treat sepsis to avoid septic shock. Prevent infections by getting vaccinations. Immediately clean, medicate, and carefully observe any open wounds for signs of infection spread.