Septic Shock

Septic Shock

A septic shock is a so-called inflammatory reaction of the organism. The body reacts to the intrusion of viruses, bacteria, fungi and toxins with multi-organ failure. If there is no timely and adequate treatment, septic shock is usually fatal. A septic shock is to be distinguished from an anaphylactic shock (allergic shock) and circulatory shock.

What is septic shock?

Septic shock is present when the symptoms of SIRS (systemic inflammatory response syndrome) appear. In addition, there must be an infectious cause (bacteria, viruses, fungi or toxins) and a systolic blood pressure of less than 90 mmHg. For testicular dystopia in dictionary, please visit dictionaryforall.com.

The low blood pressure (hypotension) must last for at least one hour despite volume substitution. In addition to fever and an accelerated heartbeat, the respiratory rate is increased and there are disturbances in the blood count.

Septic shock is caused by sepsis (blood poisoning). If organ or multiple organ failure occurs, combined with a drop in blood pressure, this is defined as septic shock.

A septic shock can be divided into three stages:

Stage 1: the beginning of septic shock – is characterized by: body temperature above 38.4 °C, stable tachycardia (accelerated heartbeat), hyperventilation, platelet count in the blood is within the normal range, intensive monitoring required.

Stage 2: septic shock: reduced platelet count, hyperdynamic or hypodynamic shock, evidence of bacteremia and endotoxemia, ventilation of the affected person is urgently required.

Stage 3a: remission: significant improvement.

Or stage 3b: treatment-refractory condition: no improvement in the symptoms, the patient’s condition cannot be influenced even by aggressive therapy, so that the septic shock ultimately leads to death.

Causes

Septic shock is caused by bacteria, viruses, fungi, or toxins that have entered the bloodstream. The introduction of bacteria is often caused by medical measures, e.g. B. punctures, operations, catheter infections or by taking certain medications.

Septic shock is usually the result of sepsis (blood poisoning). But other diseases such as B. cancer, end-stage renal disease, Lemierre syndrome, gangrene, peritonitis, as well as inflammation of the lungs, pancreas and gallbladder, can be a cause of septic shock.

Sepsis and subsequent septic shock can also result from skin burns or other open wounds.

Symptoms, Ailments & Signs

Septic shock can cause a wide range of symptoms and conditions. First, the shock reaction leads to cardiovascular problems: tachycardia, high blood pressure and blood pressure fluctuations. At the same time, blue lines or redness appear under the skin. The skin changes occur mainly on the extremities and enlarge rapidly.

The blood poisoning that accompanies this initially causes a high fever and malaise and leads to serious circulatory problems as the disease progresses. Chills and confusion also occasionally occur. Hypothermia can also occur as a result of the fever, in which the body temperature drops below 36 degrees Celsius.

The clearest sign is the red line developing towards the heart. The red line can be slightly tender and is clearly visible externally. If it reaches the heart, there is a risk of heart failure. If the course is severe, sepsis can be fatal.

Early treatment prevents serious complications and leads to a speedy recovery in 80 percent of patients without further symptoms or discomfort. Occasionally, there may be a protracted fever and physical weakness. These symptoms disappear completely within a few weeks.

Diagnosis & History

A blood test is used to diagnose septic shock. Here, a search is made for the pathogen that triggered the inflammatory chain reaction.

Furthermore, a septic shock can be recognized by the course of the disease in the case of sepsis. The first signs are red or blue lines on the arms and legs, swollen lymph nodes, high fever, tachycardia, hyperventilation, impaired consciousness, hypotension and organ failure.

Sepsis is usually accompanied by circulatory disorders, a drop in blood pressure and organ failure. If sepsis is not treated promptly and adequately, septic shock occurs as a result. If no effective countermeasures are taken or if the therapy does not work, septic shock usually ends fatally. The mortality rate for sepsis or septic shock is around 50-60 percent.

Complications

In septic shock, there is a circulatory collapse due to a drop in blood pressure, which is based on a mostly bacterial poisoning. A septic shock is therefore always highly life-threatening. The low blood pressure and small blood clots can lead to a number of serious complications.

The blood supply to vital organs such as the brain, heart, lungs or kidneys can be impaired. When body tissues do not receive enough blood, they release excess lactic acid, threatening metabolic acidosis. Furthermore, thrombocytopenia can set in because the thrombocyte survival time decreases due to the progressive poisoning processes. In addition, a shock kidney, i.e. acute kidney failure, can be expected if the urine volume decreases too much.

If the lungs are affected, symptoms such as hyperventilation due to lack of oxygen and shortness of breath can initially occur. In these cases, there is a risk of shock lung, i.e. acute lung failure. Inadequate blood flow to the gastric mucosa in connection with increased production of gastric juice can lead to a stress ulcer, i.e. stress-related damage to the gastric mucosa. If the sepsis cannot be contained, the worst complication is acute multi-organ failure, which regularly leads to death.

When should you go to the doctor?

With this disease, a doctor must always be consulted. Self-healing cannot occur, so the affected patient is dependent on medical treatment. In the worst case, the affected person dies from this shock if the disease is not treated. A doctor should be consulted if the person concerned suffers from heart palpitations and high blood pressure.

There is also severe reddening of the face and most patients also suffer from fever. If these symptoms occur, a doctor must be consulted in any case. It is not uncommon for those affected to appear confused or suffer from chills and a general feeling of illness. If this shock is not treated, it usually leads to heart failure.

In the event of such a shock, an ambulance should be called immediately or the hospital should be visited. Further treatment is then carried out in the hospital, whereby an additional stay is usually necessary.

Treatment & Therapy

Septic shock is a medical emergency and requires immediate medical attention. Depending on which pathogen was determined to be the cause of the septic shock, drug therapy with antibiotics, antivirals, antimycotics or antiparasitics is initiated.

Furthermore, a volume substitution takes place. In addition to avoiding desiccation (dehydration), the infusion liquid serves to balance the water and electrolyte balance. Since septic shock is associated with multi-organ failure, drug measures are also taken to stabilize the affected organs.

Blood clotting can also be affected in septic shock, so measures must be taken to avoid thrombosis or embolism.

The fall in blood pressure leads to a circulatory disorder in the extremities and organs. The reduced blood circulation results in a lack of oxygen, which can lead to impaired consciousness and coma. The circulatory disorder, together with the blood clotting disorder, can result in thrombosis, so that in addition to the administration of oxygen and blood-thinning agents, more liquid must be administered.

Sepsis or septic shock is often triggered by an infected wound. Because of this, it is necessary for the source of infection to be surgically eliminated.

Since breathing is often restricted, intubation is usually performed. In addition to these measures, general circulatory measures are also taken in the event of septic shock.

Prevention

A septic shock can be prevented by ensuring a sterile environment during operations in hospitals and medical practices. After the operation, the wound must be thoroughly disinfected. The daily dressing changes must also be carried out under sterile conditions.

But not only operations in the hospital can trigger a septic shock. Every wound, no matter how small, should be adequately disinfected immediately. There are disinfectants for skin and wounds that belong in every medicine cabinet in the home and at work.

Some people suffer from poor wound healing. This group should always consult a doctor – even for small wounds – to have the wound treated professionally so that sepsis and septic shock can be avoided.

Aftercare

Once you’ve had septic shock, you may be marked for life. But the body was strong enough to fight through this severe infection, even if it was damaged. It is now a question of compensating for this damage in the long term. This is generally best achieved through a healthy lifestyle. First of all, this includes nutrition.

It should be light and digestible, rich in vitamins and low in fat. If the kidneys were affected by septic shock, a low-potassium diet is also recommended. The patient should only resort to fast food in an emergency. Instead, freshly prepared dishes with lots of vegetables and salad are recommended. Toxins such as nicotine and alcohol unnecessarily burden both the liver and the entire organism.

Regulated rest periods and sufficient sleep give the body the opportunity to carry out repair measures without stress. Sport, which is best done in the fresh air, promotes blood circulation and oxygen uptake. The patient may suffer psychologically after the life-threatening shock situation.

Knowing that you almost died can be very distressing. Psychotherapeutic crisis intervention is advisable here. Of course, the patient should also avoid injuries in the future. If he does get a wound, you have to pay attention to the healing process.

You can do that yourself

Many things in life often change for patients who have suffered septic shock. Depending on the severity of the disease, the most important thing is a good healing process. Participation in self-help groups shows those affected how to regain their quality of life. Above all, the immune system needs to be strengthened in order to arm itself against new pathogens. In order to reduce the risk of a physical shock reaction, there are also other useful auxiliary measures.

Anyone suffering from diabetes mellitus should stick to the prescribed diet. People with implants, catheters or stents are also at risk and should therefore take good care of themselves. In the case of inflammation, the risk increases sharply, and immune deficiencies can also promote septic shock. For those affected, it is immanently important that they observe their bodies and notice any problems at an early stage. Regular visits to the doctor are just as much a part of everyday life for groups of people at risk as is a healthy lifestyle.

By attending a self-help group or receiving comprehensive psychotherapeutic care, those affected can learn more about this disease and how best to deal with the constant danger.

Septic Shock