Intro
Septic shock is a medical emergency and the most severe end of the sepsis spectrum. It requires rapid, protocolized care in an ICU setting.
Key Points
- Defined by persistent hypotension after fluids + need for vasopressors and elevated lactate.
- Early antibiotics, fluids, and source control save lives.
- Complications: multi-organ failure, ARDS, DIC, death.
- Survivors may experience post-sepsis syndrome (fatigue, cognitive issues, PTSD-like symptoms).
Background
Sepsis arises from a dysregulated host response to infection. In septic shock, circulatory collapse and cellular dysfunction lead to critical hypoperfusion and organ failure.
Causes or Mechanisms
Common sources: pneumonia, urinary tract, abdominal and skin/soft tissue infections; invasive devices can seed bloodstream infection.
Diagnosis / Treatment / Options
Diagnosis: clinical sepsis plus hypotension after fluids; labs often show elevated lactate and organ dysfunction.
Treatment (bundled):
- Within 1 hour: cultures (if feasible) without delaying antibiotics, broad-spectrum IV antibiotics.
- Resuscitation: IV crystalloids; vasopressors (e.g., norepinephrine) to maintain MAP ≥65 mmHg.
- Support: oxygen/ventilation, renal support as needed.
- Source control: drain abscesses, remove infected lines, surgery if indicated.
Risks / Benefits / Prognosis
Mortality remains significant; rapid, guideline-driven care reduces death and disability.
FAQ
Q: Can septic shock be prevented?
A: Preventing and promptly treating infections (vaccination, hygiene, early care for pneumonia/UTI, safe device use) lowers risk.