Septic Shock

Septic shock (formerly infectious shock) is shock from sepsis defined by inadequate tissue perfusion: persistent hypotension after volume challenge or blood lactate ≥4 mmol/L. Usually due to Gram-negative bacilli, seen in acute suppurative obstructive cholangitis, gangrenous cholecystitis, pyelonephritis, acute pancreatitis, and nosocomial infections.

Common Symptoms

Hypoxemia; shock; myocardial infarction; respiratory failure; anal sphincter transection; respiratory alkalosis; hematuria; toxemia; metabolic acidosis; hypotension

Causes and Pathogenesis

Mechanisms are not fully elucidated. Bacterial toxins trigger complex immune reactions: besides endotoxin (LPS lipid A from Gram-negative enteric walls), many mediators (TNF, leukotrienes, lipoxygenase, histamine, bradykinin, serotonin, IL-2). Initial changes: arterial/arteriolar dilation, falling SVR, normal/increased CO; later CO falls and SVR rises. Despite increased CO, capillary exchange is impaired, reducing O2 delivery and CO2/waste clearance; kidney and brain are most affected, leading to multi-organ failure and classic shock. Risk factors: immunocompromise (diabetes, cirrhosis, leukopenia, tumors, cytotoxic therapy), antibiotics/corticosteroids/ventilators, urinary/biliary/GI infection, invasive devices. Neonates, patients >35, pregnant women, and iatrogenic complications are at risk.

Treatment

Drug therapy, supportive therapy

Preventive Measures

Target the cause; use sensitive IV antibiotics and actively drain primary foci (e.g., purulent drainage).

Department to Visit

It is recommended to visit the Emergency department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.