Septic Shock

Definition

Sepsis is a systemic inflammatory response to a severe infection. The inflammatory response triggers a rapid cascade of events, such as leaking blood vessels and impaired blood flow.

Severe sepsis is associated with a drop in blood pressure. Low blood pressure reduces the amount of oxygen and nutrients going to the body's organs. This drop causes damage the body's major organs.

Septic shock occurs when adequate blood pressure can't be restored despite treatment with IV fluids. Septic shock may lead to multiple organ failure and death.

Causes    TOP

Septic shock is caused by an infection that overwhelms the body. Sepsis can be triggered by many different kinds of infections including:

  • Bacterial—most common
  • Fungal infections
  • Viral
  • Parasitic
Lung sepsis infant
An infection of the lungs has spread throughout the body, leading to septic shock.
Copyright © Nucleus Medical Media, Inc.

Risk Factors    TOP

Septic shock is more common in infants and in people over 50 years old. Other factors that may increase your chance of septic shock include:

  • Weakened immune system
  • Absence of your spleen
  • Cancer
  • Low white blood cell counts
  • Chronic diseases
  • Previous surgery

Symptoms    TOP

Septic shock may cause:

  • Fever, which may be followed by a drop in body temperature to below normal
  • Warm, flushed skin
  • Chills
  • Rapid, pounding heartbeat
  • Rapid breathing
  • Confusion
  • Reduced alertness
  • Irregular blood pressure
  • Reduced urination

Complications from septic shock may cause symptoms of:

Diagnosis    TOP

Your doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests may include the following:

  • Complete blood tests to assess white blood cell counts, inflammatory markers, oxygen levels, and kidney function
  • Cultures to check for infectious organisms
  • Electrocardiogram (EKG) to check for heart rhythm irregularities
  • Imaging tests may be used to look for specific sources of infection, such as pneumonia

Treatment    TOP

Sepsis and septic shock require immediate care. Treatment includes the following:

Supportive Measures for Shock

If you have septic shock, you will be admitted to the intensive care unit. There you will be given:

  • IV fluids
  • Medications to increase blood pressure and blood flow to your organs
  • Extra oxygen
  • Corticosteroids may be needed to reduce the inflammatory response, especially if fluids aren't working

If your lungs fail, you may be put on a mechanical ventilator to help you breathe. Other therapies or supportive measures may be used.

Medications

Once the cause of the infection is identified, you will be given high doses of one or more antibiotics or antifungal medications.

Surgery    TOP

Surgery may be performed to remove any dead tissue.

Prevention    TOP

Most cases of septic shock cannot be prevented. Treating bacterial and other infections promptly may help.

RESOURCES:

Centers for Disease Control and Prevention
http://www.cdc.gov
Society of Critical Care Medicine
http://www.sccm.org

CANADIAN RESOURCES:

Canadian Association of Emergency Physicians
http://www.caep.ca

References:

Behrman RE, et al. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders; 2007.
Dellinger RP, Levy MM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013;41(2):580-637.
Goldman L, Ausiello D, eds. Cecil Textbook of Internal Medicine. 23rd ed. Philadelphia, PA: Saunders; 2008.
Marx JA, et al. Rosen's Emergency Medicine.7th ed. St. Louis, MO: Mosby, Inc.; 2009.
Sepsis and septic shock. The Merck Manual Professional Edition website. Available at:
...(Click grey area to select URL)
Updated July 2013. Accessed December 30, 2013.
Sepsis fact sheet. National Institute of General Medical Sciences website. Available at:
...(Click grey area to select URL)
Updated November 2012. Accessed December 30, 2013.
Sepsis in adults. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated October 28, 2013. Accessed December 30, 2013.
Sepsis treatment in adults. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated December 28, 2013. Accessed December 30, 2013.
Last reviewed November 2014 by Michael Woods, MD
Last Updated: 12/30/2013