What is Septic shock ?

Septic shock is a condition where blood pressure drops to levels that endanger their lives as a result of sepsis.

Septic shock often occurs in:
- The newborn,
- Age over 50 years, and
- People with immune system disorders.


CAUSE
Septic shock caused by toxins produced by certain bacteria and due to cytokines (substances made by the immune system to fight an infection). Toxins released by the bacteria can cause tissue damage and circulatory disorders.

Risk factor for septic shock:

* Chronic disease (diabetes, blood cancer, urinary-genital tract, liver, gall bladder, intestine)
* Infection
* The use of long-term antibiotic
* Medical or surgical measures.


SYMPTOMS
Early signs of septic shock is often a decrease in mental alertness and confusion that arises within 24 hours or more before the blood pressure down. These symptoms occur due to reduced blood flow to the brain. Outpouring of blood from the heart is increased, but blood vessels widen so blood pressure falls. Breathing becomes faster so that the lungs and removing excessive carbon dioxide levels in the blood decreases.

Early symptoms include shivering, body temperature rises very quickly, warm and flushed skin, weak pulse and blood pressure fluctuated. Urine production is reduced despite increased flow of blood from the heart. In later stages, the body temperature often drops to below normal.

When the shock worsened, multiple organ failure:
- Renal: decreased urine production,
- Lung: respiratory distress and decreased oxygen levels in the blood,
- Heart: fluid retention and swelling.

May develop blood clots in the blood vessels.


Diagnosis
Blood tests showed a white blood cell count that much or less and the amount of clotting factors is decreased. If kidney failure occurs, the levels of metabolic waste products (such as urea nitrogen) in the blood will increase. Blood gas analysis showed acidosis and low oxygen concentration.

EKG showed heart rhythm irregularity of the heart, showed inadequate blood supply to the heart muscle. Blood culture was made to determine the bacteria causing the infection.


TREATMENT
At the time of septic shock symptoms arise, the patient immediately put into intensive care room for treatment. Fluids in large quantities given intravenously to raise blood pressure and should be watched closely. Can be given dopamine or nor-epinephrine to shrink blood vessels so that blood pressure rises and blood flow to the brain and the heart increases.

In the event of failure of the lungs, may be required mechanical ventilator. Antibiotics intravenously (through a vein) is given in high doses to kill bacteria. If there are abscesses, pus discharge performed. If the attached catheter that may be the cause of the infection must be removed. May need surgery to remove dead tissue, such as gangrenous tissue of the intestine.