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Describe the pathophysiology of septic shock. Outline the treatment options for septic shock. Explain the importance of improving care coordination amongst interprofessional team members to improve outcomes for patients affected by septic shock.
Septic shock is a serious medical condition that can occur when an infection in your body causes extremely low blood pressure and organ failure due to sepsis. Septic shock is life-threatening and requires immediate medical treatment. It’s the most severe stage of sepsis.
Sepsis may progress to septic shock. This is a dramatic drop in blood pressure that can damage the lungs, kidneys, liver and other organs. When the damage is severe, it can lead to death. Early treatment of sepsis improves chances for survival.
It involves the activation of circulating and fixed phagocytic cells, as well as the generation of proinflammatory and anti-inflammatory mediators. Sepsis results when the response to infection becomes generalized and involves normal tissues remote from the site of injury or infection.
With this review, we aim to provide an overview of sepsis immune pathophysiology, to update the choice of therapeutic approaches targeting different immunological mechanisms in the course of sepsis and septic shock, and to call for a paradigm shift from the pathogen to the host response as a potentially more promising angle.
Pathophysiology of Sepsis and Septic Shock. The pathogenesis of septic shock is not completely understood. An inflammatory stimulus (eg, a bacterial toxin) triggers production of pro-inflammatory mediators, including tumor necrosis factor (TNF) and interleukin (IL)-1.
Septic shock occurs in a subset of patients with sepsis and comprises of an underlying circulatory and cellular/metabolic abnormality that is associated with increased mortality.
In this chapter, we introduce the pathophysiology, diagnostic approach, initial management, and future of septic shock. Considering the purpose of this book, i.e., scenario based, we do not cover all aspects of septic shock, but focus on the early management of septic shock.
Sepsis, severe sepsis, and septic shock represent increasingly severe systemic inflammatory responses to infection. Sepsis is common in the aging population, and it disproportionately affects patients with cancer and underlying immunosuppression.
On a cellular and subcellular level, alterations and/or dysfunction in immune function/signaling, the endothelium, the intestinal epithelium and microbiota, and the coagulation cascade all appear to play a role in the pathophysiology of sepsis. We will highlight key findings in each of these topics below.