User:Mr. Ibrahem/Septic shock

Septic shock is a severe form of sepsis in which blood pressure remains low and lactate is greater than 2 mmol/L (>18 mg/dL) despite sufficient intravenous fluids. Initial symptoms may include a temperature greater than 38 C or less than 36 C, fast heart rate, narrow pulse pressure, and increased respiratory rate. More severe symptoms may include confusion and bluish skin. Complications can include acute respiratory distress syndrome and multiple organ dysfunction syndrome.

The most common type of infection is bacterial, with gram-negative bacterial infections present in 62% of cases and gram-positive bacterial infections present in 47% of cases. In less than 5% of cases viruses or parasites are involved. The most common locations of infections are the lungs (42%), blood (21%), and urine (10%), though in a third of cases the location is unclear. Risk factors for sepsis include diabetes, cancer, liver or kidney problems, corticosteroid use, burns, poor immune function, and extremes of age. It is a type of distributive shock.

Treatment involves early goal-directed therapy, with the use of antibiotics, removing infected tissue, intravenous fluids, and vasoactive agents such as norepinephrine. Other measures may include mechanical ventilation and corticosteroids. Severe sepsis occurs in about 750,000 people (300 per 100,000) a year in the United States. The risk of death is greater than 40% and some who survive are left with long term disability.