Principles of rescue for septic shock

Septic shock is a relatively serious disease manifestation. If not treated in time, it will pose a great threat to the patient's life safety. When septic shock occurs, rescue should be carried out in time, blood transfusion should be given quickly, the body's electrolytes should be replenished quickly, the infection should be controlled in time, and corresponding antibiotics can be used for treatment according to the specific pathogens to correct the patient's acid-base imbalance.

1. Replenish blood volume

First, quickly infuse isotonic saline solution or balanced salt solution, and then supplement with an appropriate amount of colloid fluid, such as plasma, whole blood, etc. CVP should be monitored during fluid replacement as a basis for adjusting the type and rate of infusion.

2. Infection Control

Treat the primary lesion as early as possible. For those with unidentified pathogens, broad-spectrum antibiotics can be used in combination based on clinical judgment, and then adjusted to sensitive but narrow-spectrum antibiotics based on the results of drug sensitivity tests.

3. Correct acid-base imbalance

Patients with septic shock often have varying degrees of acidosis, which should be corrected. Mild acidosis can be relieved by replenishing blood volume. For patients with severe acidosis, 200 ml of 5% sodium bicarbonate should be infused intravenously, and the dosage should be supplemented according to the results of blood gas analysis.

4. Use of vasoactive drugs

When shock does not improve after blood volume replacement, vasodilators may be considered; α-receptor and β-receptor stimulants may also be used in combination, such as dopamine plus metaraminol, to enhance myocardial contractility and improve tissue perfusion. In case of septicemia, the heart function is damaged to a certain extent and manifests as heart failure. In this case, scutellaria baicalensis C, dobutamine, etc. can be given.

5. Use of corticosteroids

Glucocorticoids can inhibit the release of various inflammatory mediators in the body, stabilize lysosomal membranes, reduce cell damage, and relieve SIRS. Hydrocortisone, dexamethasone or methylprednisolone are commonly used clinically for slow intravenous injection. When using it, pay attention to early use and sufficient dosage, and use it for a maximum of 48 hours, otherwise there is a possibility of complications such as stress ulcers and immunosuppression.

6. Other treatments

Nutritional support, management of DIC and vital organ dysfunction.