Septic Shock

What is 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.

What’s the difference between septic shock and sepsis?

Septic shock is the last and most dangerous stage of sepsis. Sepsis can be divided into three stages: sepsis, severe sepsis and septic shock.

• Sepsis: Sepsis is life-threatening. It happens when your immune system overreacts to an infection.
• Severe sepsis: This is when sepsis causes your organs to malfunction. This is usually because of low blood pressure, a result of inflammation throughout your body.
• Septic shock: Septic shock is the last stage of sepsis and is defined by extremely low blood pressure, despite lots of IV (intravenous) fluids.

What are the signs and symptoms of septic shock?

Septic shock is the third stage of sepsis. Early signs of sepsis can include:

• Fast heart rate.
• Fever or hypothermia (low body temperature).
• Shaking or chills.
• Warm, clammy or sweaty skin.
• Confusion or disorientation.
• Hyperventilation (rapid breathing).
• Shortness of breath.

When sepsis turns to septic shock, you may experience additional symptoms. These include:

• Very low blood pressure.
• Lightheadedness.
• Little or no urine output.
• Heart palpitations.
• Cool and pale limbs.
• Skin rash.

What causes septic shock?

Any infection can lead to sepsis which can then develop into septic shock if it worsens. Not every infection will lead to sepsis or septic shock. But, if an infection causes enough inflammation, it can develop into sepsis. Most of the common infections are from bacteria, but both viruses and fungi can also cause infections and sepsis. Infections can start anywhere but commonly begin in your lungs, bladder or stomach.

What are the risk factors for septic shock?

Your septic shock risk increases if you have a weakened immune system which increases your risk for sepsis. People with weakened immune systems include:

• Newborns.
• Those over age 65.
• People who are pregnant.
• People who use recreational drugs.
• People with artificial joints or heart valves.

People with chronic medical conditions have an increased risk of sepsis. These conditions include:

• AIDS.
• Diabetes.
• Leukemia or lymphoma.
• Immune disorders.

In addition, people who’ve had recent infections, surgeries, transplants or medical devices implanted have an increased risk of sepsis.

What are the complications of septic shock?

Septic shock is a very serious medical condition. It’s the most severe stage of sepsis. Septic shock can lead to:

• Brain damage.
• Lung failure.
• Heart failure.
• Kidney failure.
• Gangrene.
• Death.

What tests will be done to diagnose septic shock?

Your healthcare provider may suspect sepsis if you’ve had an infection and you suddenly develop a fever or hypothermia, rapid heart rate or breathing rate, or low blood pressure.

Your healthcare provider may run blood tests to check for:

• Presence of bacteria and/or infection.
• Complete blood count.
• Blood chemistries, including lactate.
• Blood oxygen levels.
• Organ malfunction.

Your healthcare provider may also collect samples of your urine, saliva, tissues and/or cerebrospinal fluid for further tests.

In addition, you may have imaging tests to find the source of infection. These imaging tests include:

• Chest X-ray.
• Computed tomography (CT) scan.
• Magnetic resonance imaging (MRI) scan.

How is septic shock treated?

If you have septic shock, you need immediate treatment. Treatment is usually in an intensive care unit (ICU).

Your healthcare provider will start you on antibiotics immediately. They will also give you fluids through your vein (intravenously) to rehydrate you and help increase your blood pressure.

You may receive oxygen through a face mask or a nasal cannula, a small plastic tube with two openings for your nostrils. A breathing tube may be placed in your windpipe (trachea) to connect you to a breathing machine (ventilator) if you can’t breathe well on your own.

In addition, you may need surgery to remove the source of the infection. Abscesses may be drained. Dead or infected tissue may be removed. Catheters, tubes and medical devices may be removed or changed.

If fluids don’t increase your blood pressure, you may receive medication to raise it. Medications such as vasopressin (Pitressin®) or norepinephrine (Levophed®) cause your blood vessels to narrow and increase the blood flow to your organs.

You may receive insulin if the septic shock has increased your blood sugar (glucose) levels.

If fluids and medication haven’t helped increase your blood pressure, you may receive corticosteroids.

How can I prevent septic shock?

If you have a bacterial infection, receive treatment right away. Antibiotics can help with the infection and prevent sepsis from occurring, which can lead to septic shock.

It’s also important to keep up to date on your vaccines. Vaccines can help prevent some infections, and they greatly lessen the severity of others. Keep in mind, some cases of septic shock can’t be prevented.

What is the survival rate of septic shock?

Septic shock is a severe, life-threatening condition. The survival rate is low. Survival depends on your age, health, cause of the condition, if you’ve had organ failure and how quickly you receive treatment. Without treatment, most people will die of septic shock. With treatment, 30% to 40% of people with septic shock die.

What is recovery like after septic shock?

Many people recover from septic shock, but it can take a long time. You may continue to have symptoms for months or years. These long-term effects are called post-sepsis syndrome. These effects can include:

• Fatigue.
• Difficulty sleeping.
• Lack of appetite.
• Weakened immune system.
• Mood disorders, anxiety or depression.
• Nightmares or flashbacks.

To help with your recovery, make sure you:

• See your healthcare provider regularly.
• Eat a healthy diet.
• Get regular exercise.
• Get enough sleep.
• Avoid infections.

When should I go to ER?

If you develop any symptoms of sepsis or septic shock, you should call 911 or go to the emergency room (ER) immediately.

Can you survive septic shock?

Septic shock is a severe medical condition. The survival rate is low, but people do survive. Survival depends on your age, health, cause of the condition, if you’ve had organ failure and how quickly you receive treatment. Without treatment, most people die of septic shock. With treatment, 30% to 40% of people with septic shock die.

What is the most common cause of septic shock?

Sepsis causes septic shock. Bacterial infections are the most common cause of sepsis. The source of the infection can be anywhere in your body. Most often, the infection will start in your lungs, abdomen or urinary tract. In some people, toxins are released by the bacteria and get into your bloodstream. This causes sepsis.

What are the three stages of sepsis?

Sepsis can be divided into three stages. The stages are sepsis, severe sepsis and septic shock:

• Sepsis: Sepsis is when your immune system overreacts to an infection and starts to attack your body’s tissues and organs.
• Severe sepsis: When your immune system starts to attack your organs, they don’t receive enough blood, causing them to malfunction. Severe sepsis describes sepsis complicated by organ malfunction.
• Septic shock: Sepsis also causes low blood pressure. Septic shock describes sepsis complicated by organ failure and blood pressure that remains low despite treatment with fluids.

How do you know if you have septic shock?

Your healthcare provider may suspect sepsis if you’ve had an infection and you suddenly develop a fever or hypothermia, rapid heart rate or breathing rate, or low blood pressure. Your healthcare provider will run additional tests to confirm the diagnosis.

A note from Cleveland Clinic

Septic shock is a severe condition. Be prepared by knowing the signs and symptoms of sepsis and septic shock. If you develop any of the symptoms, call 911 or get to the emergency room ASAP. While septic shock can be a scary diagnosis, immediate treatment is important and could save your life. If you have experienced septic shock, make sure to see your healthcare provider regularly for follow-up visits. They may also be able to provide you with additional resources to help you in your recovery.