Sepsis And Septic Shock

By:    Published: July 19, 2012

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Sepsis is a potentially life-threatening condition that results from an infection in the body. If sepsis evolves into septic shock, the possibility of death increases. Septic shock is one of the major causes of death among hospitalized patients. Nearly 50 percent of all patients admitted to the hospital with acute sepsis will not survive. Septic shock is most prevalent among the very young, very old and those who have underlying health conditions.

Definition

Sepsis is a complication that occurs as the result of an infection in the body. When an infection occurs, chemicals are released throughout the body in an effort to fight off the infection. These chemicals flow through the bloodstream and generate inflammation within the body. The inflammation that is triggered causes minuscule blood clots to form. These clots prevent oxygen and nutrients from making contact with organs, thus causing them to fail. Should sepsis evolve into septic shock, the patients blood pressure will drop significantly and that patient may not survive.

Symptoms

You may be diagnosed with sepsis if you are experiencing two or more of the following symptoms:

  • Fever greater than 101.3 F or less than 95 F
  • An accelerated heart rate of more than 90 beats per minute
  • Accelerated respirations of greater than 20 breaths per minute
  • Possible or verified infection

Additional symptoms may include:

  • Loss of color or a cold feeling in the extremities
  • Lightheadedness
  • Restlessness
  • Sleepiness
  • Agitation

Severe septic shock indicates there is some dysfunction involving the organs. Your diagnosis will be elevated to SEVERE should you display any of one of the following symptoms:

  • Blotchy or spotted areas on skin
  • A substantial decrease or absence of urine output
  • Sudden altered mental status
  • Diminished platelet count
  • Trouble breathing
  • Atypical heart function

Patients are diagnosed with septic shock only after they display the symptoms associated with sepsis coupled with a significantly low blood pressure.

Causes

Any type of bacteria can cause sepsis and lead to septic shock. In rare cases, viruses or fungi can be the initial cause of infection. Contaminants released by the invading bacteria or fungi can lead to tissue damage, which can contribute to a decrease in blood pressure and organ dysfunction. While any bacteria can cause sepsis, the more common infections likely to contribute to the development of sepsis include:

  • Pneumonia
  • Infections of the abdomen
  • Kidney infections
  • Infections within the bloodstream

Risk Factors

Typically, sepsis occurs in people who are very young or very old or those who have other illnesses, especially illnesses that cause a weakening of the immune system. Over the past several years, there seems to be an increase in the number of patients with sepsis and septic shock; this can be attributed to the fact that people are living longer and more people are living with conditions leading to a weakened immune system or the fact that there are many more instances of drug resistant bacteria causing infections.

Risk factors associated with sepsis and septic shock include:

  • Very young age
  • Advanced age
  • Weakened immune system
  • Hospitalized patients
  • Patients with breathing tubes or catheters
  • Diabetes
  • Recent surgery
  • Recent infection
  • Recent use of steroids
  • Leukemia
  • Lymphoma
  • Long term regimen of antibiotics

Diagnostic Tests

Diagnosing sepsis can be very difficult especially because many of the symptoms mirror other illnesses. Accurately diagnosing sepsis early on is the key to survival. If you are suspected of having sepsis, your doctor will likely order a multitude of tests to identify the original infection and accurately diagnosis your condition. Such tests may include:

  • Blood tests to check for infection, clotting difficulties, organ function, and oxygen function and electrolyte levels.
  • Laboratory tests including urine analysis, wound secretion examination and respiratory secretion examinations.
  • Imaging tests such as x-rays, CT scans, MRI and ultrasound to pinpoint the underlying site of infection.

Treatment Options

If identified early, an aggressive treatment regimen may be able to contain sepsis and prevent it from evolving into septic shock, thus improving the patient’s survival rate. A person with severe sepsis will need to be closely monitored in the hospital, most likely in the intensive care unit. Septic shock is a medical emergency and extreme measures may be required to stabilize the patient and prevent death. People with sepsis may undergo treatment procedures such as:

  • Medications such as antibiotics to fight infection
  • Medications to increase blood pressure
  • Intravenous fluids
  • Blood sugar stabilizers
  • Pain medication
  • Sedatives
  • Oxygen support
  • Breathing machine
  • Kidney dialysis
  • Surgery to remove infection or abscess

Complications

If sepsis becomes severe it can begin to affect the blood flow to major organs including the brain and heart, causing a variety of complications. Complications associated with severe sepsis are:

  • Respiratory failure
  • Heart failure
  • Kidney failure
  • Blood clots
  • Death of tissue in the extremities; gangrene leading to limb amputation
  • Death

Considerations

Swift treatment of infection can be helpful in the prevention of sepsis; however, once the sepsis is underway it may not be possible to prevent septic shock from setting in. Septic shock has a very high death rate of nearly 50 percent.

Sepsis is a condition brought about by an underlying infection. Sepsis and septic shock can happen to anyone but is most prevalent in very young children or the elderly and those with compromised immune systems. Patients with mild cases of sepsis have a good chance of recovering, however those with severe sepsis or septic shock have a near 50 percent chance of succumbing to the condition.

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