infections
Sepsis and Septic Shock
Treatment of Sepsis and Septic Shock
Antibiotics Intravenous fluids Oxygen Removal of the source of infection Sometimes medications to increase blood pressure Doctors immediately treat sepsis and septic shock with antibiotics. Doctors do not wait until test results confirm the diagnosis because a delay in antibiotic treatment greatly decreases the chances of survival. Treatment occurs in a hospital. People with septic shock or who are severely ill are immediately admitted to an intensive care unit for treatment. When choosing the initial antibiotics, doctors consider which bacteria are most likely to be present, which depends on where the infection started, for example the bacteria that cause urinary tract infection are typically different from the bacteria that cause skin infection. Also, doctors consider what bacteria are most common in infections in the person's community and in their particular hospital. Often, two or three antibiotics are given together to increase the chances of killing the bacteria, particularly when the source of the bacteria is unknown. Later, when the test results are available, doctors can substitute the antibiotic that is most effective against the specific bacteria causing the infection. People with septic shock are also given large amounts of fluid by vein (intravenously) to increase the amount of fluid in the bloodstream and thus increase blood pressure. Giving too little fluid is not effective but giving too much fluid can cause severe lung congestion. Oxygen is given through a mask, through nasal prongs, or through a breathing (endotracheal) tube if one has been inserted. If needed, a Mechanical Ventilation (a machine that helps air get into and out of the lungs) is used to help with breathing. If present, abscesses are drained. Catheters, tubes, or other medical devices that may have started the infection are removed or changed. Surgery may be done to remove infected or dead tissue. If intravenous fluids do not increase blood pressure, doctors sometimes give medications, such asnorepinephrine(which cause blood vessels to narrow), to raise blood pressure and increase blood flow to the brain, heart, and other organs. However, because these medications may narrow blood vessels within organs, they sometimes decrease the amount of blood flow through the organs. Sometimes people who have septic shock develop a high blood sugar (glucose) level. Because high blood sugar impairs how the immune system responds to an infection, doctors giveinsulinby vein to people to lower the level of glucose in the blood. Corticosteroids (such ashydrocortisone) may be given by vein to people whose blood pressure remains low despite having received adequate fluids and drugs to increase blood pressure and despite having the source of their infection treated. 