Septic shock

Septic shock

Septic shock is a life-threatening condition that happens when your blood pressure drops to a dangerously low level after an infection.

Any type of bacteria can cause the infection. Fungi such as candida and viruses can also be a cause, although this is rare.

At first the infection can lead to a reaction called sepsis. This begins with:

• weakness
• chills
• a rapid heart and breathing rate

Left untreated, toxins produced by bacteria can damage the small blood vessels, causing them to leak fluid into the surrounding tissues.

This can affect your heart’s ability to pump blood to your organs, which lowers your blood pressure and means blood doesn’t reach vital organs, such as the brain and liver.

Phone 999 immediately if:

You think that you or someone in your care has symptoms of septic shock like:

• low blood pressure (hypotension) that makes you feel dizzy when you stand up
• a change in your mental state, like confusion or disorientation
• diarrhoea
• nausea and vomiting
• cold, clammy and pale skin

Who is more at risk of developing septic shock?

People with a weakened immune system have an increased risk of developing septic shock.

This includes:

• newborn babies
• elderly people
• pregnant women
• people with long-term health conditions, such as diabetes, cirrhosis or kidney failure
• people with lowered immune systems, such as those with HIV or AIDS or those receiving chemotherapy

Treating septic shock

You’ll usually be admitted to an intensive care unit (ICU) so your body’s functions and organs can be supported while the infection is treated. In some cases treatment may start in the emergency department.

Treatment may include:

• oxygen therapy
• fluids given directly through a vein (intravenously)
• medication to increase your blood flow
• antibiotics
• surgery (in some cases)

Oxygen therapy

To help you breathe more easily, you’ll be given oxygen through a face mask, a tube inserted into your nose, or an endotracheal tube inserted into your mouth. If you have severe shortness of breath, a mechanical ventilator may be used.

Increasing blood flow

You’ll probably be given fluids directly into a vein. This will help raise your blood pressure by increasing the amount of fluid in your blood.

To increase the blood flow to your vital organs, such as your brain, liver, kidneys and heart, you may be prescribed inotropic medicines or vasopressors.

Inotropic medicines

Inotropic medicines (inotropes), such as dobutamine, stimulate your heart. They increase the strength of your heartbeat, which helps get oxygen-rich blood to your tissues and organs, where it’s needed.

Vasopressors

Vasopressors include:

• dopamine
• adrenaline
• noradrenaline

These medicines will cause your blood vessels to narrow, increasing your blood pressure and the flow of blood around your body. This will allow your vital organs to start functioning properly.

Antibiotics

Antibiotics are often used to treat the associated bacterial infection. The type of antibiotic used depends on the type of bacterial infection and where in the body the infection started.

You may be started on antibiotics immediately to increase your chances of survival. Initially, two or three types of antibiotics may be used. The most effective type of antibiotic can be used once the bacterium responsible for the infection is identified.

Surgery

In severe cases of sepsis or septic shock, the large decrease in blood pressure and blood flow can kill organ tissue. If this happens, surgery may be required to remove the dead tissue.

Complications of septic shock

The chances of surviving septic shock will depend on:

• the cause of infection
• the number of organs that have failed
• how soon treatment is started

Complications of septic shock can include:

• inability of the lungs to take in enough oxygen (respiratory failure)
• the heart not being able to pump enough blood around the body (heart failure)
• kidney failure or injury
• abnormal blood clotting

These are serious health conditions that will need to be treated urgently. Septic shock can be fatal because of complications like these.