Emergencies

Septic Shock

2025-09-15

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.

Further Reading

• WHO: Sepsis
• NIGMS: Sepsis Facts

Related Guides

• Sepsis
• Pneumonia
• Urinary Tract Infection

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