Septic shock

Septic shock is a subclass of distributive shock, which occurs secondary to massive vasodilation causing an increase in capillary permeability which leads to intervascular volume deficits that lead to tissue hypoxia.

The process of infection by bacteria or fungi can result in systemic signs and symptoms that are variously described. In rough order of serverity, theses would be bacteremia or fungemia; septicemia; systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis or sepsis syndrome; septic shock; refractory septic shock; multiple-organ dysfunction syndrome; and death.

The condition develops as a response to certain microbial molecules which trigger the production and release of cellular mediators, including cytokines, such as tumor necrosis factor (TNF), which act to stimulate immune response. Besides TNFα, other cytokines involved in the development of septic shock include interleukin-1β, and interferon γ.

Septic shock can cause such effects as organ failure and death. The most common victims of septic shock are children and the elderly, as their immune system cannot cope with the infection as well as a full-grown adult. Septic shock is a very serious condition, and kills about 50% of its victims.

Treatment primarily consists of antimicrobial chemotherapy, removal of the source of infection, and hemodynamic, respiratory, and metabolic support. Antimediator agents may be of some limited use in certain clinical situations.

see also: anaphylactic shock and neurogenic shock

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