What is septic shock? How to treat it?

Shock is a disease that can lead to direct death. Generally speaking, there are many types of shock, and septic shock is one of them. So, what is septic shock?

What is septic shock?

Septic shock refers to shock caused by sepsis, formerly known as infectious shock. It is defined as insufficient tissue perfusion in the patient, that is, persistent hypotension after volume test or blood lactate concentration ≥4mmol/L. It is usually caused by Gram-negative bacteria and is mainly seen in acute suppurative obstructive cholangitis, gangrenous cholecystitis, pyelonephritis, acute pancreatitis and some nosocomial infections.

How is septic shock treated?

Emphasis should be placed on infection, shock and maintenance of vital signs. Oxygen should be given through a nasal tube to support breathing. If necessary, endotracheal intubation or tracheotomy and mechanical artificial respiration can be performed.

Anti-shock treatments such as massive fluid replacement and correction of acidosis are required.

Early and prompt antibiotic treatment can be lifesaving. The treatment plan for septic shock with unknown pathogens can be gentamicin or tobramycin plus a third-generation cephalosporin (cefotaxime or ceftriaxone, or ceftazidime if Pseudomonas is suspected); if Gram-positive bacteria are likely to be the cause, vancomycin should be added; if the source of infection is in the abdomen, anti-anaerobic drugs (such as metronidazole) should be used. High-dose single-dose therapy such as ceftazidime 2 g IV every 8 hours or imipenem 500 mg IV every 6 hours may be effective but is not recommended. If drug-resistant Staphylococci or Enterococci are suspected, vancomycin must be used. Once the results of culture and susceptibility testing are obtained, the antibiotic treatment regimen should be adjusted accordingly. Antibiotics should be continued for several days after shock disappears and the primary infection focus is cleared.

Hemofiltration is a reliable method that has emerged in recent years and can remove inflammatory mediators and other functions.