Septic Shock: Causes, Risk Factors, Signs, Symptoms, Diagnosis, Treatment

Septic shock is a fatal medical condition which occurs as a complication of severe infection and sepsis where the toxins produce an inflammatory response in the entire body, which if not treated immediately, leads to multiple organ failure and death. Elderly people or individuals with a weak or compromised immune system are easy targets for developing septic shock. Inflammation occurs as a result of infection and sepsis, which in turn leads to formation of tiny blood clots. These blood clots cause hindrance in the supply of oxygen and nutrients to the vital organs resulting in failure of organs and acute septic shock. Patient experiences acute hypotension (low blood pressure) and can also die.

Septic shock is a serious and life threatening condition. Almost half of the patients suffering from a septic shock will not survive. The chances of surviving a septic shock depends on the source/cause of the infection, number of organs affected, and the immediateness of the treatment started.

Treatment comprises of antibiotics, large amounts of I.V. fluids, corticosteroids, vasopressors and surgery.

1. Sepsis: In this stage the infection reaches the bloodstream which produces inflammation in the entire body.
2. Severe Sepsis: In this stage, the infection blocks/hinders the blood flow to vital organs, such as brain or kidneys, causing organ failure. Formation of blood clots also causes gangrene or tissue death in the arms, legs, fingers and toes.
3. Septic Shock: In this stage, patient experiences a significant drop in the blood pressure leading to respiratory, heart or multiple organ failure and eventually death.

The cause of sepsis is infection (bacterial, fungal, viral). Bacterial infections tend to develop when a patient is in the hospital, after a surgery etc. Sepsis develops commonly from:

• Infections of abdominal or digestive systems.
• Infections of the lung, such as bronchitis, pneumonia, lower respiratory tract infections.
• Reproductive system infection.
• Urinary tract infection.
• Drug resistant bacteria are the common cause of sepsis.
• Long-term hospitalization and major surgery increases the risk of sepsis and septic shock.
• Old age and people with weakened immune systems are at a higher risk for developing septic shock.
• Certain medical conditions like HIV or cancer treatment weakens the immune system and increases the risk of septic shock.
• Intravenous drug use increases the risk of septic shock.
• Medical conditions like diabetes increase the risk of septic shock.
• Serious patients like those who are admitted in the ICU are at an increased risk for a septic shock.
• Newborns and pregnant women are more vulnerable towards developing a septic shock.
• Prolonged use of breathing tubes, intravenous catheters etc. give easy access to bacteria and increases the risk of septic shock.

• Appearance of patches of discolored skin.
• Decreased urine output.
• Extremely low blood pressure.
• Low platelet count.
• Confusion or change in metal status.
• High fever or low body temperature (hypothermia).
• Difficulty in breathing.
• Abnormal or rapid heart rate, like palpitations.
• Chills.
• Pain in the abdomen.
• Severe weakness and lightheadedness.

If you experience any of the above signs and symptoms after a surgery, then seek immediate medical attention. Early treatment of septic shock increases the chances of survival.

• The causative bacteria.
• Cause of low platelet count.
• Assess the excess waste products in the blood.
• Assess for any abnormality in the function of the liver and kidneys.
• Arterial blood gas is done to determine the amount of oxygen present in the blood.
• Find out electrolyte imbalances.

• Urine tests.
• Wound secretion test.
• Mucus secretion test.
• Brain and spinal fluid test.
• X-rays are done to take a look at organs such as lungs.
• CT scan can be done determine if any infection is present in the pancreas, appendix or bowel region.
• Ultrasound to find out any infection in the gallbladder or ovaries.
• MRI to look for soft tissue infections, like spinal abscesses.

The earlier the diagnosis of sepsis is made and the early the treatment is started, the better the chances of survival are for the patient. Treatment needs to be prompt and aggressive. After the diagnosis of sepsis is confirmed, patient is admitted to ICU (Intensive Care Unit) for treatment.

• Intravenous (I.V.) antibiotics are started to fight the infection.
• Vasopressors are those medications which cause constriction of the blood vessels and increase a person’s blood pressure.
• Insulin is given to stabilize blood sugar.
• Low dose corticosteroids are given to fight the inflammation.
• Patient is started on large amounts of IV fluids to prevent dehydration and to increase the blood pressure.
• A respirator may also be required to help in breathing.
• Surgery may be needed to remove the source of infection, like draining an abscess filled with pus or to debride the infected tissue.

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