Definition: Shock or septic shock and sepsis is a potentially lethal condition of blood pressure due to bacteria in the blood.
Septic shock is a possible consequence of bacteremia or bacteria in the bloodstream. Bacterial toxins, and the immune system’s response to them, cause a dramatic drop in blood pressure which can lead to multiple organ failures, such as respiratory failure, causing rapid death. Toxic shock syndrome is a type of septic shock.
Causes of sepsis
Certain types of bacteria can produce and release complex molecules during an infection, called endotoxins, producing a dramatic response in the body’s immune system. Endotoxins are particularly dangerous because they become very dispersed, affecting the blood vessels. The arteries and smaller arterioles open more, increasing the total volume of the circulatory system. At the same time, the walls of the blood vessels become permeable, allowing the fluid to seep into the tissues, reducing the amount of fluid left in the circulation.
Other changes caused by the immune response can cause the blood to clot in the extremities, further reducing circulation through the organs.
Septic shock is seen more frequently in patients with immune system depression and is usually due to bacteria acquired during treatment in the hospital. The immune system is depressed due to drugs used to treat cancer, autoimmune diseases, organ transplants, immunodeficiency diseases such as AIDS, malnutrition, chronic drug abuse, and long-term illnesses, which increase the likelihood of succumbing to the bacterial infection. Bacteremia is common in pre-existing infections, such as urinary tract infections, gastrointestinal, and skin ulcers. Surgical procedures, catheters, or intravenous equipment can introduce bacteria into the bloodstream.
Toxic shock syndrome occurs more frequently in women who menstruate due to highly absorbent tampons; These buffers provide the breeding ground for staphylococcal bacteria, which can enter the bloodstream through small tears in the lining of the vagina. Toxic shock syndrome has decreased markedly since this type of tampon was removed from the market.
Septic shock is characterized by fever, malaise, chills, and nausea. The first sign of shock is confusion and decreased consciousness.
Other symptoms include:
- Rapid heartbeat.
- Rapid and superficial breathing.
- Decrease in urine.
- Red spots on the skin.
Septic shock can cause the “adult respiratory distress syndrome,” in which fluid builds up in the lungs, and breathing becomes very shallow and complex. This condition can lead to a collapse of ventilation, in which the patient can no longer breathe adequately without assistance.
Septic Shock Diagnostics
The diagnosis is made by measuring blood pressure, heart rate, and breathing rate. Blood pressure can be controlled with a catheter device inserted into the pulmonary artery to the lungs. Blood cultures are done to determine the type of bacteria responsible. Oxygen levels, carbon dioxide, and acidity in the blood are also monitored to assess changes in respiratory function.
Septic shock is initially treated with a combination of antibiotics and fluid replacement. The antibiotic is chosen based on the bacteria present, although two or more types of antibiotics can be used initially until the affected organism is identified. Coagulation and hemorrhage can be treated with plasma or platelet transfusions. Dopamine can be given to increase blood pressure further if necessary. Breathing difficulty is treated with mechanical ventilation and supplemental oxygen, either by using a nose piece or a tube in the trachea through the throat.