What is sepsis and how does it affect the body. Who is at risk of developing sepsis. What are the signs and symptoms of sepsis. How is sepsis diagnosed and treated. Why is early recognition of sepsis crucial for survival. How can sepsis be prevented. What are the long-term effects of sepsis on survivors.

Defining Sepsis: A Potentially Fatal Response to Infection

Sepsis is a severe and potentially life-threatening medical condition that occurs when the body’s response to an infection spirals out of control. It triggers a chain reaction throughout the body, leading to widespread inflammation and potential organ failure if left untreated.

How does sepsis develop? The process typically begins with a localized infection, often in the lungs, urinary tract, skin, or gastrointestinal system. As the body attempts to fight off this infection, it can sometimes overreact, releasing a flood of chemicals into the bloodstream. This excessive immune response can cause widespread inflammation and damage to tissues and organs throughout the body.

Key Statistics on Sepsis

• At least 1.7 million adults in America develop sepsis annually
• Approximately 350,000 adults who develop sepsis die during hospitalization or are discharged to hospice
• 1 in 3 people who die in a hospital had sepsis during that hospitalization
• In nearly 87% of cases, sepsis or the infection causing it starts before a patient is admitted to the hospital

The Origins and Causes of Sepsis

While any infection can potentially lead to sepsis, certain types are more commonly associated with this condition. What are the primary culprits behind sepsis?

• Bacterial infections: These are the most frequent cause of sepsis
• Viral infections: Including COVID-19 and influenza
• Fungal infections: Though less common, they can also trigger sepsis

Is sepsis contagious? No, sepsis itself cannot be spread from person to person. However, the underlying infections that lead to sepsis can often be transmitted. This is why proper hygiene and infection control measures are crucial in preventing the spread of infections that may potentially result in sepsis.

Identifying High-Risk Groups for Sepsis

While sepsis can affect anyone, certain populations are at a higher risk of developing this dangerous condition. Who should be particularly vigilant about the possibility of sepsis?

• Adults 65 years or older
• Individuals with weakened immune systems
• People with chronic medical conditions (e.g., diabetes, lung disease, cancer, kidney disease)
• Those who have recently experienced severe illness or hospitalization
• Survivors of previous sepsis episodes
• Children younger than one year old

Understanding these risk factors is crucial for both individuals and healthcare providers. It allows for increased vigilance and potentially earlier intervention if sepsis is suspected.

Recognizing the Signs and Symptoms of Sepsis

Early detection of sepsis is critical for improving outcomes. What are the key indicators that someone may be developing sepsis?

• High heart rate or weak pulse
• Confusion or disorientation
• Extreme pain or discomfort
• Fever, shivering, or feeling very cold
• Shortness of breath
• Clammy or sweaty skin

It’s important to note that these symptoms can vary from person to person, and sepsis may present differently in children compared to adults. Additionally, these signs are not exclusive to sepsis and may be indicative of other medical conditions. Therefore, a professional medical assessment is always necessary to confirm a sepsis diagnosis.

The Progression to Septic Shock

In severe cases, sepsis can advance to septic shock, a critical condition characterized by a dramatic drop in blood pressure. This can lead to organ damage and significantly increases the risk of death. What are the specific symptoms of septic shock?

• Inability to stand up
• Extreme drowsiness or difficulty staying awake
• Significant changes in mental status, such as severe confusion

Immediate Action: What to Do If Sepsis Is Suspected

Given the life-threatening nature of sepsis, prompt action is essential. How should one respond if sepsis is suspected?

1. Seek immediate medical care. Do not wait to see if symptoms improve.
2. When consulting a healthcare professional, explicitly ask, “Could this infection be leading to sepsis?”
3. If symptoms are severe, go to the emergency room or call emergency services.
4. When calling for emergency assistance, inform the operator if you suspect sepsis or have COVID-19.
5. If possible, wear a mask before medical help arrives to protect healthcare workers.

Remember, with rapid recognition and treatment, most people survive sepsis. However, delays in seeking medical attention can significantly reduce the chances of a positive outcome.

Diagnosis and Treatment of Sepsis

Diagnosing sepsis can be challenging as its symptoms often overlap with other conditions. How do healthcare professionals confirm a sepsis diagnosis?

• Physical examination to assess vital signs and overall condition
• Blood tests to check for signs of infection, organ damage, and abnormal blood clotting
• Imaging tests such as X-rays, CT scans, or MRIs to locate the source of infection
• Urine or stool samples to identify the specific pathogen causing the infection

Once sepsis is confirmed, what does treatment typically involve?

• Admission to an intensive care unit for close monitoring
• Administration of intravenous antibiotics to fight the underlying infection
• Fluid replacement to maintain blood pressure and prevent organ damage
• Oxygen therapy or mechanical ventilation if breathing is compromised
• Medications to support blood pressure and organ function
• In severe cases, dialysis for kidney failure or surgery to remove infected tissue

The specific treatment plan will depend on the severity of sepsis, the source of the infection, and the patient’s overall health status. Early and aggressive treatment is crucial for improving outcomes and reducing the risk of long-term complications.

Preventing Sepsis: Strategies for Reducing Risk

While it’s not always possible to prevent sepsis, there are steps individuals can take to reduce their risk. What are some effective strategies for sepsis prevention?

• Practice good hygiene, including regular handwashing
• Keep cuts and wounds clean and covered until healed
• Stay up to date on vaccinations, including flu shots and pneumococcal vaccines
• Manage chronic conditions effectively
• Seek prompt medical attention for infections
• Follow prescribed antibiotic regimens completely
• Be aware of sepsis symptoms, especially if you’re in a high-risk group

For healthcare providers, implementing sepsis screening protocols and adhering to infection control practices can help identify and manage sepsis cases earlier, potentially improving outcomes for patients.

Long-Term Effects: Life After Sepsis

Surviving sepsis is a significant achievement, but many patients face ongoing challenges after recovery. What are some of the potential long-term effects of sepsis?

• Post-sepsis syndrome (PSS), characterized by physical and psychological symptoms
• Cognitive impairment, including memory problems and difficulty concentrating
• Weakened immune system, increasing susceptibility to future infections
• Chronic pain or fatigue
• Organ damage, potentially requiring ongoing medical care
• Mental health issues, such as anxiety, depression, or post-traumatic stress disorder (PTSD)

How can sepsis survivors manage these long-term effects? A comprehensive approach often includes:

• Regular follow-up appointments with healthcare providers
• Physical therapy to address muscle weakness and mobility issues
• Occupational therapy to help with daily living activities
• Cognitive rehabilitation for those experiencing mental fog or memory problems
• Mental health support, including counseling or support groups
• Lifestyle modifications to support overall health and reduce the risk of future infections

Recovery from sepsis is often a long journey, and patients may require ongoing support from healthcare providers, family, and community resources. Understanding the potential long-term effects can help patients and their caregivers better prepare for the recovery process and seek appropriate care when needed.

Advancing Sepsis Research and Awareness

Despite its prevalence and severity, sepsis remains a condition that many people are unfamiliar with. How can we improve sepsis outcomes on a broader scale?

• Increased public awareness campaigns to educate about sepsis symptoms and risk factors
• Enhanced training for healthcare providers to recognize and treat sepsis promptly
• Continued research into new diagnostic tools and treatment approaches
• Development of more effective antibiotics to combat drug-resistant infections
• Implementation of standardized sepsis protocols in healthcare settings
• Improved data collection and analysis to track sepsis cases and outcomes

Organizations like the Sepsis Alliance and the Global Sepsis Alliance play crucial roles in advancing these initiatives. They work to raise awareness, promote research, and advocate for policies that can help reduce the global burden of sepsis.

The Role of Technology in Sepsis Management

How is technology contributing to improved sepsis care? Several innovative approaches are being developed and implemented:

• AI-powered algorithms to predict sepsis risk based on patient data
• Electronic health record systems with sepsis alert features
• Rapid diagnostic tests to identify pathogens and guide treatment
• Wearable devices to monitor vital signs and detect early signs of infection
• Telemedicine platforms to facilitate remote monitoring and consultation

These technological advancements hold promise for improving sepsis detection, treatment, and outcomes. However, their effectiveness ultimately depends on their integration into clinical practice and the continued education of healthcare providers and patients about sepsis recognition and management.

Global Impact: Sepsis as a Worldwide Health Concern

While the statistics provided earlier focus on the United States, sepsis is a global health issue. How does sepsis affect populations worldwide?

• The World Health Organization estimates that sepsis affects more than 30 million people worldwide each year
• Sepsis potentially causes 6 million deaths annually
• Low- and middle-income countries are disproportionately affected by sepsis
• Maternal and neonatal sepsis is a significant contributor to maternal and infant mortality in developing countries

What factors contribute to the global burden of sepsis?

• Limited access to healthcare in some regions
• Lack of resources for proper infection control and treatment
• Higher rates of antibiotic resistance in certain areas
• Insufficient awareness about sepsis among both the public and healthcare providers
• Challenges in implementing standardized sepsis protocols across diverse healthcare systems

Addressing sepsis on a global scale requires coordinated efforts from international health organizations, governments, healthcare systems, and research institutions. Initiatives aimed at improving sanitation, increasing access to vaccines and antibiotics, and enhancing healthcare infrastructure in underserved areas can all contribute to reducing the worldwide impact of sepsis.

The Economic Burden of Sepsis

Beyond its human toll, sepsis also imposes a significant economic burden on healthcare systems and societies. What are some of the financial implications of sepsis?

• High costs associated with intensive care treatment
• Extended hospital stays and potential readmissions
• Long-term care needs for sepsis survivors with ongoing health issues
• Lost productivity due to illness and long-term disabilities
• Strain on healthcare resources, particularly during outbreaks or pandemics

Investing in sepsis prevention, early detection, and effective treatment not only saves lives but can also lead to substantial cost savings for healthcare systems in the long run. This economic perspective further underscores the importance of prioritizing sepsis awareness and management at both national and global levels.

Empowering Patients and Caregivers: Knowledge as a Tool Against Sepsis

Education plays a crucial role in combating sepsis. How can individuals and caregivers arm themselves with knowledge to protect against this condition?

• Learn to recognize the signs and symptoms of sepsis
• Understand personal risk factors and take appropriate precautions
• Stay informed about proper wound care and infection prevention techniques
• Advocate for oneself or loved ones in healthcare settings
• Participate in sepsis awareness campaigns and community education programs

What resources are available for those seeking to learn more about sepsis?

• Educational materials from reputable health organizations
• Sepsis awareness events and webinars
• Support groups for sepsis survivors and their families
• Online courses and training modules for healthcare professionals
• Informational websites and helplines dedicated to sepsis awareness

By fostering a well-informed public, we can create a powerful force in the fight against sepsis. Knowledgeable patients and caregivers are more likely to seek timely medical attention, ask the right questions, and potentially save lives through early recognition of sepsis symptoms.

The Importance of Continued Vigilance

Even as medical knowledge and treatments advance, why is it crucial to maintain ongoing vigilance against sepsis?

• The emergence of new pathogens and antibiotic-resistant strains
• Changing demographics, with aging populations at higher risk
• Increased use of immunosuppressive therapies and invasive medical procedures
• The potential for sepsis to complicate other medical conditions
• The need for continuous improvement in sepsis recognition and management

By staying alert to the ongoing threat of sepsis and adapting our approaches as new challenges arise, we can continue to make progress in reducing its impact on individuals and communities worldwide. The fight against sepsis is ongoing, requiring sustained effort, research, and collaboration across all levels of healthcare and society.

What is Sepsis? | Sepsis

• What is sepsis?
• Is sepsis contagious?
• What causes sepsis?
• Who is at risk?
• What are the signs & symptoms?
• What should I do if I think I might have sepsis?
• Fact Sheet, Brochure, and Conversation Starter

Anyone can get an infection, and almost any infection, including COVID-19, can lead to sepsis. In a typical year:

• At least 1.7 million adults in America develop sepsis.
• At least 350,000 adults who develop sepsis die during their hospitalization or are discharged to hospice.
• 1 in 3 people who dies in a hospital had sepsis during that hospitalization
• Sepsis, or the infection causing sepsis, starts before a patient goes to the hospital in nearly 87% of cases.

Sepsis is the body’s extreme response to an infection. It is a life-threatening medical emergency.   Sepsis happens when an infection you already have triggers a chain reaction throughout your body.  Infections that lead to sepsis most often start in the lung, urinary tract, skin, or gastrointestinal tract. Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death.

Is sepsis contagious?

You can’t spread sepsis to other people. However, an infection can lead to sepsis, and you can spread some infections to other people.

Sepsis happens when…

Transcript: Sepsis happens when [TXT 1 1 KB]

What causes sepsis?

Infections can put you or your loved one at risk for sepsis. When germs get into a person’s body, they can cause an infection. If you don’t stop that infection, it can cause sepsis. Bacterial infections cause most cases of sepsis. Sepsis can also be a result of other infections, including viral infections, such as COVID-19 or influenza, or fungal infections.

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Who is at risk?

Anyone can develop sepsis, but some people are at higher risk for sepsis:

Adults 65 or older

People with weakened immune systems

People with chronic medical conditions, such as diabetes, lung disease, cancer, and kidney disease

People with recent severe illness or hospitalization

People who survived sepsis

Children younger than one

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What are the signs & symptoms?

A person with sepsis might have one or more of the following signs or symptoms:

High heart rate or weak pulse

Confusion or disorientation

Extreme pain or discomfort

Fever, shivering, or feeling very cold

Shortness of breath

Clammy or sweaty skin

A medical assessment by a healthcare professional is needed to confirm sepsis.

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What should I do if I think I might have sepsis?

Sepsis is a medical emergency. If you or your loved one has an infection that’s not getting better or is getting worse, ACT FAST.

Get medical care IMMEDIATELY. Ask your healthcare professional, “Could this infection be leading to sepsis?” and if you should go to the emergency room.

If you have a medical emergency, call 911. If you have or think you have sepsis, tell the operator. If you have or think you have COVID-19, tell the operator this as well. If possible, put on a mask before medical help arrives.

With fast recognition and treatment, most people survive.  Treatment requires urgent medical care, usually in an intensive care unit in a hospital, and includes careful monitoring of vital signs and often antibiotics.

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Fact Sheet, Brochure, and Conversation Starter (Print Only)

Protect Yourself and Your Family from Sepsis [PDF – 2 pages]

It’s Time to Talk about Sepsis [PDF – 2 pages]

Start the Conversation Today [PDF – 2 Pages]

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Sepsis – Symptoms & causes

Overview

Sepsis is a serious condition in which the body responds improperly to an infection. The infection-fighting processes turn on the body, causing the organs to work poorly.

Sepsis may progress to septic shock. This is a dramatic drop in blood pressure that can damage the lungs, kidneys, liver and other organs. When the damage is severe, it can lead to death.

Early treatment of sepsis improves chances for survival.

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Symptoms

Symptoms of sepsis

Symptoms of sepsis may include:

• Change in mental status.
• Fast, shallow breathing.
• Sweating for no clear reason.
• Feeling lightheaded.
• Shivering.
• Symptoms specific to the type of infection, such as painful urination from a urinary tract infection or worsening cough from pneumonia.

Symptoms of sepsis are not specific. They can vary from person to person, and sepsis may appear differently in children than in adults.

Symptoms of septic shock

Sepsis may progress to septic shock. Septic shock is a severe drop in blood pressure. Progression to septic shock raises the risk of death. Symptoms of septic shock include:

• Not being able to stand up.
• Strong sleepiness or hard time staying awake.
• Major change in mental status, such as extreme confusion.

When to see a doctor

Any infection could lead to sepsis. Go to a health care provider if you have symptoms of sepsis or an infection or wound that isn’t getting better.

Symptoms such as confusion or fast breathing need emergency care.

Causes

Any type of infection can lead to sepsis. This includes bacterial, viral or fungal infections. Those that more commonly cause sepsis include infections of:

• Lungs, such as pneumonia.
• Kidney, bladder and other parts of the urinary system.
• Digestive system.
• Bloodstream.
• Catheter sites.
• Wounds or burns.

Risk factors

Some factors that increase the risk infection will lead to sepsis include:

• People over age 65.
• Infancy.
• People with lower immune response, such as those being treated for cancer or people with human immunodeficiency virus (HIV).
• People with chronic diseases, such as diabetes, kidney disease or chronic obstructive pulmonary disease (COPD).
• Admission to intensive care unit or longer hospital stays.
• Devices that go in the body, such as catheters in the vein, called intravenous, or breathing tubes.
• Treatment with antibiotics in the last 90 days.
• A condition that requires treatment with corticosteroids, which can lower immune response.

Complications

As sepsis worsens, vital organs, such as the brain, heart and kidneys, don’t get as much blood as they should. Sepsis may cause atypical blood clotting. The resulting small clots or burst blood vessels may damage or destroy tissues.

Most people recover from mild sepsis, but the mortality rate for septic shock is about 30% to 40%. Also, an episode of severe sepsis raises the risk for future infections.

Septic shock. What is septic shock?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

Septic shock is a serious pathological condition that occurs when a massive intake of bacterial endotoxins into the blood. Accompanied by tissue hypoperfusion, a critical decrease in blood pressure and symptoms of multiple organ failure. The diagnosis is made on the basis of the general clinical picture, which combines signs of damage to the lungs, cardiovascular system (CVS), liver and kidneys, and centralization of blood circulation. Treatment: massive antibiotic therapy, infusion of colloid and crystalloid solutions, maintenance of CCC activity by introducing vasopressors, correction of respiratory disorders by mechanical ventilation.

ICD-10

R57.2

• Causes
• Pathogenesis
• Classification
• Symptoms of septic shock
• Complications
• Diagnostics
• Treatment of septic shock
• Prognosis and prevention
• Prices for treatment

General

Septic shock (SS) is also called infectious-toxic shock (ITS). As an independent nosological unit, pathology was first described in the 19th century, however, a full-fledged study with the development of specific anti-shock measures began no more than 25 years ago. It can occur with any infectious process. Most often occurs in patients of surgical departments, with meningococcal septicemia, typhoid fever, salmonellosis and plague. It is common in countries where the largest number of bacterial and parasitic diseases is diagnosed (Africa, Afghanistan, Indonesia). More than 500,000 people around the world die each year from TSS.

Septic shock

Causes

In the vast majority of cases, pathology develops against the background of weakened immune responses. It occurs in patients suffering from chronic severe diseases, as well as in the elderly. Due to physiological characteristics, sepsis is more often diagnosed in men. The list of the most common diseases in which TTS events can occur includes:

• Foci of purulent infection. Signs of a systemic inflammatory reaction and associated disorders in the functioning of internal organs are noted in the presence of volumetric abscesses or phlegmon of soft tissues. The risk of a generalized toxic response increases with a long course of the disease, the absence of adequate antibiotic therapy, and the patient’s age over 60 years.
• Prolonged stay in the ICU. Hospitalization in the intensive care unit is always associated with the risk of sepsis and infectious shock. This is due to constant contact with microflora resistant to antibacterial drugs, weakening of the body’s defenses as a result of a serious illness, the presence of multiple gates of infection: catheters, gastric tubes, drainage tubes.
• Wounds. Violations of the integrity of the skin, including those that occurred during surgery, significantly increase the risk of infection with a highly contagious flora. TSS begins in patients with contaminated wounds who have not received timely care. Tissue trauma during surgery becomes the cause of a generalized infection only if the rules of asepsis and antisepsis are not followed. In most cases, septic shock occurs in patients who have undergone manipulations on the stomach and pancreas. Another common cause is diffuse peritonitis.
• Taking immunosuppressants. Immune depressant drugs (mercaptopurine, krizanol) are used to suppress the rejection reaction after organ transplantation. To a lesser extent, the level of self-protection decreases with the use of chemotherapeutic agents – cytostatics intended for the treatment of oncological diseases (doxorubicin, fluorouracil).
• AIDS. HIV infection in the AIDS stage leads to the development of atypical sepsis, provoked not by a bacterial culture, but by a fungus of the genus Candida. Clinical manifestations of the disease are characterized by a low degree of severity. The lack of an adequate immune response allows the pathogenic flora to multiply freely.

The causative agent of sepsis is gram-positive (streptococci, staphylococci, enterococci) and gram-negative (Enterobacter cloacae, Clostridium pneumoniae) bacteria. In many cases, cultures are insensitive to antibiotics, making it difficult to treat patients. Septic shock of viral origin is currently controversial among specialists. Some representatives of the scientific world argue that viruses are unable to cause pathology, others that an extracellular life form can provoke a systemic inflammatory response, which is the pathogenetic basis of TSS.

Pathogenesis

The symptoms are based on the uncontrolled spread of inflammatory mediators from the pathological focus. In this case, activation of macrophages, lymphocytes and neutrophils occurs. A systemic inflammatory response syndrome occurs. Against this background, peripheral vascular tone decreases, the volume of circulating blood decreases due to increased vascular permeability and fluid stagnation in the microvasculature. Further changes are due to a sharp decrease in perfusion. Insufficient blood supply causes hypoxia, ischemia of internal organs and disruption of their function. The most sensitive is the brain. In addition, the functional activity of the lungs, kidneys and liver worsens.

In addition to SVR, endogenous intoxication plays an important role in the formation of septic shock. In connection with a decrease in the efficiency of excretory systems, products of normal metabolism accumulate in the blood: creatinine, urea, lactate, guanine and pyruvate. In internal environments, the concentration of intermediate results of lipid oxidation (skatol, aldehydes, ketones) and bacterial endotoxins increases. All this causes severe changes in homeostasis, acid-base balance disorders, disturbances in the functioning of receptor systems.

Classification

The state of shock is classified according to pathogenetic and clinical principles. Pathogenetically, the disease can be “warm” and “cold”. Warm shock is characterized by an increase in cardiac output against the background of a decrease in overall vascular tone, endogenous hypercatecholaminemia, and dilation of intradermal vessels. The phenomena of organ failure are expressed moderately. The cold variety is manifested by a decrease in cardiac output, a sharp decrease in tissue perfusion, centralization of blood circulation, and severe MOF. According to the clinical course, septic shock is divided into the following varieties:

• Compensated. Consciousness is clear, safe, the patient is inhibited, but fully contactable. Arterial pressure is slightly reduced, the level of SBP is not less than 90 mm Hg. Tachycardia is detected (PS <100 bpm). Subjectively, the patient feels weakness, dizziness, headache and decreased muscle tone.
• Subcompensated. The skin is pale, the heart sounds are deaf, the heart rate reaches 140 beats per minute. SBP <90 mm. rt. Art., Respiration is rapid, shortness of breath up to 25 movements / min. Consciousness is confused, the patient answers questions with a delay, poorly understands what is happening around, where he is. Speech is quiet, slow, unintelligible.
• Decompensated. Marked depression of consciousness. The patient answers in monosyllables, in a whisper, often after 2-3 attempts. Motor activity is practically absent, the reaction to pain is weak. The skin is cyanotic, covered with sticky cold sweat. The heart sounds are deaf, the pulse on the peripheral arteries is not determined or is sharply weakened. Heart rate up to 180 beats / min, respiratory rate 25-30, shallow breathing. BP below 70/40, anuria.
• Terminal (irreversible). Consciousness is absent, the skin is marbled or gray, covered with bluish spots. Pathological breathing according to the type of Biot or Kussmaul, the respiratory rate decreases to 8-10 times / minute, sometimes breathing stops completely. SBP less than 50 mm Hg. pillar. There is no urination. The pulse is hardly palpable even on the central vessels.

Symptoms of septic shock

One of the defining signs of TSS is arterial hypotension. It is not possible to restore the level of blood pressure even with an adequate infusion volume (20-40 ml / kg). To maintain hemodynamics, it is necessary to use pressor amines (dopamine). Acute oliguria is noted, diuresis does not exceed 0.5 ml/kg/hour. Body temperature reaches febrile values ​​- 38-39 ° C, it is poorly reduced with the help of antipyretics. To prevent convulsions caused by hyperthermia, it is necessary to use physical methods of cooling.

90% of cases of SS are accompanied by respiratory failure of varying severity. Patients with decompensated and terminal course of the disease need hardware respiratory support. The liver and spleen are enlarged, compacted, their function is impaired. There may be intestinal atony, flatulence, stools mixed with mucus, blood and pus. In the later stages, symptoms of disseminated intravascular coagulation occur: petechial rash, internal and external bleeding.

Complications

Septic shock leads to a number of severe complications. The most common of these is multiple organ failure, in which the function of two or more systems is impaired. First of all, the central nervous system, lungs, kidneys and heart suffer. Somewhat less common damage to the liver, intestines and spleen. Mortality among patients with MOF reaches 60%. Some of them die 3-5 days after being removed from a critical state. This is due to organic changes in internal structures.

Another common consequence of TSS is bleeding. With the formation of intracerebral hematomas, the patient develops a clinic of acute hemorrhagic stroke. The accumulation of extravasate in other organs can lead to their compression. A decrease in blood volume in the vascular bed potentiates a more significant decrease in blood pressure. DIC against the background of infectious-toxic shock causes the death of the patient in 40-45% of cases. Secondary organ damage, provoked by microthromboses that occur at the initial stage of coagulopathy formation, is observed in almost 100% of patients.

Diagnostics

The diagnosis is established by an anesthesiologist-resuscitator. The assumption is based on clinical data, however, it is possible to accurately determine the existing condition only if there are results of hardware and laboratory studies. If septic shock is suspected, all tests are done in an emergency mode, “according to cito”. Resuscitation activities should begin without waiting for the end of the support services. A comprehensive examination necessary to determine and confirm TTS includes:

• Examination and physical examination. Implemented directly by the attending physician. The specialist detects the characteristic clinical signs of a shock state. For this, tonometry, a visual assessment of the color of the skin, features of respiratory movements, counting the pulse and respiratory rate, auscultation of the heart and lungs are performed. If complications are suspected, an assessment of the neurological status is necessary for symptoms of cerebral hemorrhage.
• Hardware research. Has an auxiliary value. The patient is shown to control the condition using an anesthetic monitor. The screen of the device displays information about the value of blood pressure, heart rate, degree of blood oxygen saturation (with lung failure SpO2<90%) and coronary rhythm. Against the background of respiratory disorders and toxic damage to the myocardium, tachycardia, arrhythmia and blockade of intracardiac conduction may occur.
• Laboratory research. Allows you to identify existing violations of homeostasis, failures in the work of internal organs. In patients with shock of septic origin, elevated levels of creatinine (> 0.177 mmol / l), bilirubin (> 34.2 μmol / l), lactate (> 2 mmol / l) are found. Thrombocytopenia (<100 × 10⁹/l) indicates a violation of coagulation. With progressive anemia, erythrocytes are 1.5-2.5 million per 1 mm3, hemoglobin is below 90 g/l. venous blood pH <7.3 (metabolic acidosis).

Treatment of septic shock

Patients are given intensive care. Treatment is carried out in intensive care units using the methods of hardware and drug support. The attending physician is a resuscitator. Consultation with an infectious disease specialist, cardiologist, gastroenterologist and other specialists may be required. It is required to transfer the patient to artificial lung ventilation, round-the-clock supervision of nurses, parenteral feeding. Mixtures and products intended for introduction into the stomach are not used. All methods of exposure are conditionally divided into pathogenetic and symptomatic:

• Pathogenetic treatment. If sepsis is suspected, the patient is prescribed antibiotics. The scheme should include 2-3 drugs of various groups with a wide spectrum of action. The selection of the drug at the initial stage is carried out empirically, in accordance with the expected sensitivity of the pathogen. At the same time, blood is taken for sterility and susceptibility to antibiotics. The result of the analysis is prepared within 10 days. If by this time it was not possible to select an effective drug regimen, the study data should be used.
• Symptomatic treatment. It is selected taking into account the existing clinical picture. Usually patients receive massive infusion therapy, glucocorticosteroids, inotropic agents, antiplatelet agents or hemostatics (depending on the state of the blood coagulation system). In severe cases of the disease, blood products are used: fresh frozen plasma, albumin, immunoglobulins. If the patient is conscious, the introduction of analgesic and sedative drugs is indicated.

Prognosis and prevention

Septic shock has a poor prognosis for life. With a subcompensated course, about 40% of patients die. Decompensated and terminal varieties end in the death of 60% of patients. In the absence of timely medical care, mortality reaches 95-100%. Some patients die a few days after the elimination of the pathological condition. Prevention of TSS consists in the timely relief of foci of infection, the competent selection of antibiotic therapy in surgical patients, compliance with antiseptic requirements in departments involved in invasive manipulations, and the maintenance of an adequate immune status in representatives of the HIV-infected stratum of the population.

Sources

1. Resuscitation and intensive care// Zhdanov G.G., Zilber A.P. – 2007.
2. Management of patients with sepsis and septic shock in a multidisciplinary hospital / Sapicheva Yu.Yu., Likhvantsev VV. – 2015.
3. Sepsis and septic shock / Kuzkov V.V. – 2015.
4. This article was prepared based on the materials of the site: https://www.krasotaimedicina.ru/

IMPORTANT
Information from this section cannot be used for self-diagnosis and self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests.