Understanding Sepsis and Septic Shock

May 6, 2025

Sepsis and Septic Shock

Overview

  • Sepsis: A life-threatening condition caused by the body's excessive response to an infection, damaging its own tissues.
  • Septic Shock: A severe form of sepsis characterized by a body-wide deficiency of blood supply, leading to oxygen deprivation, waste product buildup, and potential organ failure.

Symptoms

  • Fever
  • Weakness
  • Sweating
  • Rapid heart rate
  • Increased breathing rate
  • Signs of septic shock include:
    • Decreased blood pressure
    • Signs of organ damage (e.g., confusion, reduced urine output)
    • Changes in skin condition (warm or flushed becoming cold, sweaty, mottled or bluish)

Causes

  • Any infection can lead to sepsis.
  • Common infections leading to sepsis:
    • Bacterial infections in the lungs, digestive, and urinary organs.
    • Post-surgery infections or infected catheters.
  • Septic Shock is more common in:
    • Newborns
    • Elderly individuals
    • Pregnant women
    • Those with compromised immune systems or chronic diseases
  • Other risk factors:
    • Extended hospital stays
    • Invasive devices
    • Overuse of antibiotics or corticosteroids

Pathogenesis

  • Immune system overwhelmed by infection.
  • Systemic cytokine release causing:
    • Widespread vasodilation
    • Capillary fluid leakage
    • Activation of coagulation process leading to blood clots
    • Possible bleeding due to depleted clotting factors
  • Results in:
    • Poor capillary flow
    • Reduced oxygen supply
    • Impaired removal of carbon dioxide and waste
    • Organ dysfunction and potential failure

Diagnosis

  • Primarily clinical diagnosis with confirmation of infection.
  • Elevated blood lactate levels indicate shock.
  • Blood tests for organ damage and infection.
  • Cultures from urine, respiratory or wound secretions.
  • Imaging tests to identify infection source.
  • Rule out other causes of shock.

Treatment

  • Early and aggressive treatment is critical
    • Intravenous fluids and vasopressors to restore blood flow.
    • Broad-spectrum antibiotics initially; specific antibiotics once organism is identified.
    • Additional measures to control infection.
    • Supportive care:
      • Supplemental oxygen
      • Mechanical ventilation or dialysis in case of organ failure.