Septic shock is defined as a serious complication of sepsis, in which even with appropriate treatment with fluid replacement and antibiotics, the person continues to have low blood pressure and lactate levels above 2 mmol/L, parameters that are evaluated periodically in the hospital to check the patient’s progress, response to treatment and the need for other procedures.
Septic shock is considered a challenge because when the patient reaches this stage of the disease it is already more weakened, in addition to the higher infectious concentration and a higher prevalence of toxic substances produced by microorganisms.
- Because of lower blood pressure.
- It is common for people with septic shock to also experience greater blood circulation difficulties.
- So less oxygen reaches important organs such as the brain.
- Heart and kidneys.
- Causing other.
- More specific signs and symptoms of septic.
- Such as decreased urinary flow and changes in mental state.
Treatment of septic shock is performed in the Intensive Care Unit (ICU), using medications and antibiotics to regulate heart and kidney function and eliminate the microorganism responsible for infection, as well as monitor pressure and lactate levels.
Since septic shock is considered a complication of sepsis, the signs and symptoms presented by the patient are the same, with high and persistent fever and increased heart rate, in addition, in case of septic shock, it is also possible to observe:
Symptoms of septic shock occur when the microorganism reaches the bloodstream and releases its toxins, which stimulate the immune system to produce and release inflammatory cytokines and mediators to combat this infection, if the patient does not respond to treatment or if the toxicity of the microorganisms is very high, the patient can progress to severe sepsis and then septic shock.
Due to the large amount of toxins, there may be changes in the amount of oxygen reaching the organs, which can lead to organic failures and endanger the life of the person.
The occurrence of septic shock is related to the resistance of microorganisms to treatment, in addition to the person’s immune system. People who have been hospitalized longer, who have diseases that compromise immunity, have recently had surgery, are malnourished, or who are older., are at increased risk of developing septic shock.
Other possible causes of septic shock are the presence of infected catheters and probes, as hospital crews are in direct and daily contact with the hospitalized patient, thus the microorganism can spread more easily into the bloodstream, proliferate and release toxins that eventually compromise functioning.oxygen to the tissues, characterizing septic shock.Learn more about the causes of septic shock.
Diagnosis of septic shock is based on a person’s clinical examination and laboratory tests.Typically, a blood test is done to determine if the number of blood cells changes (red blood cells, white blood cells and platelets), if there is a problem with the kidney function, what is the concentration of oxygen in the blood and whether there is a change in the amount of electrolytes present in the blood.Other tests your doctor may prescribe are related to the identification of the microorganism that caused the crash.
Diagnosis is conclusive for septic shock when, in addition to the signs and symptoms characteristic of sepsis, an increase in lactate concentration and a persistence of low blood pressure is identified even after treatment.
Treatment of septic shock should be performed in the ICU (Intensive Care Unit) and aims to eliminate the agent causing sepsis and thus resolve septic shock.In addition, it is indicated the use of vasoactive drugs to regulate blood pressure, in addition to the replenishment of water to increase the amount of blood and, therefore, favor the transport of oxygen to tissues.
If septic shock is confirmed, a potent antibiotic should be introduced, even if the focus of the infection is not yet known, to ensure that the microorganism responsible for the infection is eliminated as quickly as possible, which decreases the body’s immune response.
Treatment is done with the use of antimicrobials (antibiotics) depending on the identified microorganism, discover the test that helps you identify the best antibiotic.
In case of septic shock, blood circulation is extremely affected, making it difficult for the body to oxygenate.High doses of serum in the vein, approximately 30 ml per kg, are recommended to help maintain acceptable blood flow and improve drug response.
Due to the drop in blood pressure, which is not resolved by hydration in the vein alone, it is generally necessary to use blood pressure-increasing medications, called vasopressors to achieve an average blood pressure of at least 65 mmHg.
Examples of these drugs include norepinephrine, vasopressin, dopamine and adrenaline, which are drugs that should be used with close clinical follow-up to avoid additional complications.Another option is to use drugs that increase your heart rate, such as dobutamine.
This may be necessary in patients who have signs of insufficient blood flow and who have haemoglobin anemia below 7 mg/dL.See the main indications of blood transfusion.
Corticosteroids, such as hydrocortisone, may be indicated as a means to reduce inflammation, however, there are only benefits in cases of refractory septic shock, i.e. in cases where blood pressure cannot be improved even with hydration and medication use.
Hemodialysis is not always indicated, however, it can be a solution in severe cases where the rapid elimination of excess electrolytes, acidity in the blood or when the kidneys do not function properly.