- Mortality Rate
Septic shock facts
- Septic shock describes a catastrophic situation where infection overwhelms the body's immune system and potentially causes organ failure and death.
- By definition, blood pressure is low, organs like the heart, lung, kidney, and liver fail to work properly, and medications are required to support and maintain blood pressure in a normal range
- Infections that cause sepsis and shock usually arise from the lung (pneumonia), abdomen, or urinary tract.
- Patients in septic shock need treatment in the ICU (intensive care unit).
- Early administration of intravenous antibiotics is the mainstay of treatment.
- Mortality rates are as high as 50% for people in septic shock.
What is septic shock?
The definition of septic shock is ever changing as the medical community learns more about how the body fails in the face of overwhelming infection. The Society of Critical Care Medicine and the European Society of Intensive Care Medicine agreed upon the most recent definitions in 2017.
Sepsis is a life-threatening bacterial infection that causes a generalized inflammatory response in the body that affects the immune system and causes it to not respond properly to the infection. This may result in the failure of the body's organs.
The formal definition of sepsis: "life-threatening organ dysfunction caused by a dysregulated host response to infection." The SOFA score (sequential sepsis related organ failure assessment -- a scoring system to assess and track a patients severity of sepsis) needs to be 2 or more.
Septic shock is a worsening of sepsis and hypotension (low blood pressure) requiring medications (vasopressors) to increase blood pressure into the normal range and elevated lactate levels in the blood (lactate is a measure of waste products on the blood) define it. Vasopressors are intravenous medications that are continuously infused that increase blood pressure by narrowing arteries and increasing the heart's pumping capabilities.
The formal definition of septic shock: "circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone. These patients can be clinically identified by a vasopressor requirement to maintain a MAP ≥ 65mmHg and serum lactate >2mmol/L in the absence of hypovolemia."
SOFA criteria assign points for blood pressure, platelet count, lung function (oxygen levels in the blood), brain function (Glasgow Coma Scale), and liver and kidney function.
The quick SOFA score (qSOFA) measures blood pressure, respiratory rate, and Glasgow Coma Scale).
Doctors do not understand the exact mechanism as to why sepsis and septic shock occur.
What are the causes and risk factors of septic shock?
Bacterial infections that invade the body and overwhelm the immune system cause sepsis and septic shock.
Most commonly, the initial infection arises in the lung (pneumonia), kidneys (urinary tract infection), or abdomen (GI=gastrointestinal) tract.
Less commonly, infections may begin in the skin (cellulitis or abscess), central nervous system (meningitis), and bone (osteomyelitis).
Risk factors for developing septic shock include the following:
- Patients at extremes of age, including the elderly and the very young
- Those with underlying medical illnesses like diabetes, liver disease, kidney disease, or cancer
- Patients with immune compromise: This may include those on chemotherapy or other medications that affect the body's ability to fight infection.
- IV drug users
- Delay in making the diagnosis of an infection
- Delay in starting antibiotic treatment increases the risk of developing sepsis
What are septic shock symptoms and signs?
Patients in septic shock are critically ill. In addition to the signs and symptoms of the underlying infection, they may also have
How do doctors diagnose septic shock?
An initial diagnosis begins with the care provider taking a history and performing a physical exam to try to find the source of the infection. Because these patients are critically ill and unstable, the history and physical often occur at the same time as medical professionals take blood tests and X-rays, and start the patient on intravenous fluids.
Initial blood tests may include a complete blood count (CBC), chemistries to look at electrolyte levels, kidney and liver function, coagulation tests, and blood lactate levels.
Searching for the source of infection may include getting a urine sample and chest X-ray. Other X-rays and CT scans will depend upon where the search for the source of infection takes the provider and patient.
Medical professionals perform blood cultures and urine cultures to try and identify the type of bacteria causing the infection.
Your doctor may perform a lumbar puncture to obtain a sample of cerebral spinal fluid if there is concern for meningitis or encephalitis. Medical professionals will then culture the cerebral spinal fluid.
What are treatments for septic shock?
The initial treatment for septic shock incorporates the ABCs of resuscitation (airway, breathing, circulation). Patients in septic shock need to be admitted to an intensive care unit for treatment. This may include intubating the patient and using a ventilator to help with breathing.
Intravenous fluids support blood pressure. By definition, for it to be septic shock, a vasopressor medication (for example, dopamine, dobutamine, epinephrine, norepinephrine) also needs to be required to help elevated blood pressure.
Early intravenous antibiotics are important to fight the underlying infection and empiric broad spectrum antibiotic therapy is recommended. Even if the source of infection is known, the type of bacteria, and how susceptible it might be to a specific antibiotic is not. For that reason, your doctor will start you on multiple antibiotics, and as test results return, only those antibiotics that work against a specific infection will be continued.
The cause of the original infection, as well as what organs are failing, will determine other treatment options.
What are the complications of septic shock?
By definition, septic shock requires that various organs in the body fail to work. These include the heart, lungs, liver, and kidneys among others. If the infection cannot be controlled and treated, at the same as vital signs are being restored (circulation and breathing), the patient may die.
What is the prognosis and mortality rate for septic shock?
Septic shock is a catastrophic worsening of sepsis. The prognosis is dire, even with the best of intensive care, with mortality rates approaching 50%. With early diagnosis and aggressive treatment, mortality rates may be closer to 10%.
- Attachment Theory: What It Is, Stages & the Different Attachment Styles
- Gentle Parenting: What It Is, Techniques & Discipline
- U.S. Nursing Homes Fail to Report Many Serious Falls, Bedsores: Study
- The Younger You Get Diabetes, the Higher Your Risk for Dementia Later
- FDA Grants Full Approval to Paxlovid to Treat COVID-19
- More Health News »
Health Solutions From Our Sponsors
Top Septic Shock Related Articles
FeverAlthough a fever technically is any body temperature above the normal of 98.6 F (37 C), in practice, a person is usually not considered to have a significant fever until the temperature is above 100.4 F (38 C). Fever is part of the body's own disease-fighting arsenal; rising body temperatures apparently are capable of killing off many disease-producing organisms.
Anxiety DisordersAnxiety is a feeling of apprehension and fear characterized by symptoms such as trouble concentrating, headaches, sleep problems, and irritability. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. Treatment for anxiety may incorporate medications and psychotherapy.
Bacterial Infections 101Get more information on bacterial skin infections, which bacteria cause food poisoning, sexually transmitted bacteria, and more. Explore the most common bacterial infections.
dextranDextran is a prescription medication used to treat hypovolemia (decreased volume of circulatory plasma blood) resulting from surgery, trauma, severe burns, or other causes of bleeding. Dextran may be used alone or with other medications. Common side effects of dextran include mild itching, rash, body aches, numbness or tingly feeling, nausea, vomiting, stomach pain, diarrhea, mild dizziness, weakness, low fever, and brown discoloration of your skin. Do not take if breastfeeding.
dopamineDopamine is a medication administered intravenously to correct imbalances in the blood circulation dynamics (hemodynamics) caused by heart attack (myocardial infarction), cardiac arrest, open-heart surgery, trauma, septic shock, kidney failure, and decompensated heart failure. Side effects of dopamine include cardiovascular effects (chest pain [angina pectoris], high or low blood pressure [hypertension/hypotension] and others), nausea, vomiting, excessive urination, elevation of creatinine/blood urea nitrogen (BUN), increase in blood glucose levels, anxiety, headache, shortness of breath (dyspnea), and others. Consult your doctor if pregnant or breastfeeding.
dopamineDopamine hydrochloride is a prescription injection medication prescribed to correct hemodynamic status in people with shock syndrome due to trauma, open-heart surgery, kidney failure, congestive heart failure, and other causes of shock syndrome. Common side effects of dopamine include disordered breathing, nausea, vomiting, headache, and increased blood urea nitrogen. Serious side effects of dopamine include abnormal heart rhythm, increased or decreased blood pressure, increased pressure in the eye, and gangrene in the extremities.
Giapreza (angiotensin II)Giapreza (angiotensin II) is a vasoconstrictor to increase blood pressure in adults with septic or other distributive shock. Angiotensin II is a naturally occurring peptide hormone of the renin-angiotensin-aldosterone system (RAAS) that causes vasoconstriction and an increase in blood pressure.
Is Sepsis Contagious?Sepsis is a potentially life-threatening infection that may be caused by bacteria, fungi, viruses, or parasites. Sepsis spreads within the body from the infection site. Treatment of sepsis typically involves the administration of intravenous medications.
Nausea and VomitingNausea and vomiting are symptoms of many conditions including motion sickness, pregnancy, emotional stress, gallbladder disease, and other illnesses. Learn about causes, treatment, and when to be concerned.
plasma protein fractionPlasma protein fraction is a blood product used for the treatment of shock and low blood volume (hypovolemia) from plasma fluid loss due to burns, crushing injuries, abdominal emergencies, or any other cause where there is a significant loss of plasma fluids and not red blood cells. It is also used as an emergency treatment of shock due to hemorrhage, which may be followed by blood transfusion if required. Common side effects of plasma protein fraction include nausea, vomiting, excessive salivation, headache, back pain, chills, fever, redness of skin (erythema), hives (urticaria), severe allergic reaction (anaphylaxis), flushing, fluid in lungs (pulmonary edema), shortness of breath (dyspnea), low blood pressure (hypotension), and rapid heart rate (tachycardia).
Sepsis (Blood Poisoning)Sepsis (blood poisoning) is a potentially deadly infection with signs and symptoms that include elevated heart rate, low or high temperature, rapid breathing and/or a white blood cell count that is too high or too low and has more than 10% band cells. Most cases of sepsis are caused by bacterial infections, and some cases are caused by fungal infections. Treatment requires hospitalization, IV antibiotics, and therapy to treat any organ dysfunction.
What Is the Difference Between Sepsis and Septic Shock?Find out more about the main differences between sepsis and septic shock. Learn more about the treatments available to help those diagnosed with either sepsis or septic shock.
What Happens When Your Body Goes Into Septic Shock?Septic shock is a life-threatening condition. Learn what septic shock is, how doctors diagnose septic shock, septic shock signs, and what is done to treat septic shock.