Septic shock is caused by an infection that triggers an immune response, leading to organ failure and death. Understanding its pathophysiology is crucial for prevention and treatment. Treatment involves aggressive infection treatment and supportive care such as fluid infusions, mechanical ventilation, and dialysis.
The pathophysiology of septic shock involves a series of interactions between an infectious organism and a host that can lead to multisystem organ failure and death. It begins when a patient becomes infected with an organism such as a bacterium or fungus, usually one that produces toxins as metabolic byproducts. These trigger an immune response that spirals out of control, compromising the cardiovascular system and leading to hypoperfusion throughout the body. When organs begin to develop oxygen deprivation, they fail and are no longer able to sustain life.
Doctors have noted cases of septic shock for centuries and continue to struggle to understand why some patients develop this potentially fatal complication and others don’t. Research into the pathophysiology of septic shock provides important information on how to prevent and treat this condition. Treatment ideally begins with prevention through aggressive treatment for infections. Once a patient develops shock, supportive care such as fluid infusions, mechanical ventilation, and dialysis may be needed.
The first step in the pathophysiology of septic shock is the initial infection with an organism that releases toxins into the body. These lock onto immune cells and begin to trigger a cascade as the immune system kicks in to fight the infection. Levels of cytokines, proteins used to signal immune cells, begin to rise and this can become a tipping point where the immune system effectively kicks into overdrive. As it hunts down the infectious organism, it also starts harming the body, triggering the release of more immune cells.
Blood vessels begin to dilate as the heart rate slows, causing a drop in blood pressure. Without adequate blood pressure, the heart cannot circulate freshly oxygenated blood throughout the body. Starting in the extremities, organs develop ischemia, oxygen deprivation that can lead to tissue death if left untreated. Organs also experience ischemia, particularly those with high blood requirements, such as the liver and kidneys. When they fail, a series of chain reactions can begin to occur, and the end result of the pathophysiology of septic shock is coma and eventual death.
The onset of septic shock can be very rapid once the patient begins to reach tipping point. This makes understanding the pathophysiology of septic shock very important for healthcare professionals who need to be able to intervene to provide treatment. They may use drugs to raise blood pressure, increase fluid volume, and use other measures to prevent ischemia, for example. If a patient goes into shock, supportive care is needed to help them stay alive, and recovery is not guaranteed after extensive organ damage.
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