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Septic Shock by Krisha McCoy, MS

Definition

Septic shock is a condition in which blood pressure falls dangerously. It may occur in patients with serious infections. Very low blood pressure will slow blood flow. Organ failure may occur if the blood flow is too low.

Causes

Septic shock is caused by sepsis. Sepsis can be triggered by many different kinds of infections including:

Bacterial
Viral
Parasitic
Fungal infections

Sepsis

Risk Factors

The following factors increase your chance of septic shock:

Age: newborns and people over age 50
Weakened immune system
Low white blood cell counts
Chronic diseases
Previous surgery

Symptoms

If you experience any of these do not assume it is due to septic shock. These symptoms may be caused by other, less serious health conditions. If you experience any one of them, see your doctor.

Confusion
Reduced alertness
Irregular blood pressure
Chills
Fever, which may be followed by a drop in body temperature
Warm, flushed skin
Rapid, pounding heartbeat
Rapid breathing
Reduced urination
Kidney failure
Lung failure
Heart failure
Blood clots

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include the following:

Blood tests to measure white blood cells, oxygen levels, platelet count, lactic acid, and metabolic waste
Blood tests and cultures to check for infectious organisms
Electrocardiogram (ECG)—to check for heart rhythm irregularities

Treatment

Talk with your doctor about the best plan for you. Treatment options include 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—delivered directly into a vein
Drugs to increase blood flow
Extra oxygen

If your lungs fail, you may be put on a mechanical ventilator. It will 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.

Surgery

Surgery may be performed to remove any dead tissue.

Prevention

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://sccmcms.sccm.org/SCCM/

CANADIAN RESOURCES:

Canadian Association of Emergency Physicians http://www.caep.ca/
Health Canada http://www.hc-sc.gc.ca/

References:

Behrman RE, et al. Nelson Textbook of Pediatrics . 18th ed. Philadelphia, PA: Saunders; 2007.
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: what you should know. Society of Critical Care Medicine website. Available at: http://www.sccm.org/SCCM/Patient-Family+Resources/Support+Brochures/Sepsis.htm . Accessed September 26, 2006.
Septic shock. Merck website. Available at: http://www.merck.com/mmhe/print/sec17/ch191/ch191c.html . Accessed September 26 2006.

Last reviewed October 2012 by Peter Lucas, MD

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