Septic shock diagnosis and its treatment

Authors

  • Mohd Rafi Reshi Department of Pharmacology, Govt. Medical College Kathua, Jammu and Kahmir, India
  • Nusrat Nabi Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
  • Muzamil Muzaffar Department of Physiology, Govt. Medical College Kathua, Jammu and Kahmir, India
  • Saman Anees Department of Amraze Niswan Wa Atfal, SUMER, Jamia Hamdard, New Delhi, India
  • Nausheen Yusuf Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
  • Atiya Qasim Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
  • Maaz Naqvi Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20241658

Keywords:

Intensive care unit, Septic shock, Pathophysiology, Treatment

Abstract

In critical care, sepsis continues to be a major cause of mortality. The pathogenic, diagnostic, and therapeutic panorama of sepsis is no longer restricted to the critical care unit: many patients who enter treatment through other doors, both inside and outside the hospital, develop severe illness. Next, administer fluids and broad-spectrum antibiotics after taking the proper cultures. Step up the treatment to include monitoring urine output, blood gases for base excess, lactate, haemoglobin, and glucose if the situation does not get better within the following six hours. These will dictate how bicarbonate, insulin, fluids, transfusions, and vasopressors are managed. The patient should be sent to intensive care if the hypotension doesn't improve (septic shock). Sepsis can now be treated with methods that have produced better results with other illnesses. New medicines have been created as a result of a better understanding of the biology of severe sepsis and septic shock, placing a strong emphasis on early detection and aggressive treatment. The major priorities continue to be prevention through screening, preventing cross infection, and prudent antibiotic usage.

References

Perez-Nieto OR, Alarcon MA, Puente MP, Diaz JSS, Tomas ED, Lopez EIZ. Challenges in the Haemo-dynamic Management of Septic Shock. Sepsis in Critical Care. 2022;2(22):78-83.

Seymour CW, Rosengart MR. Septic Shock Advances in Diagnosis and Treatment. Clin Rev Educ. 2015;314(7):709-17.

Stearns-Kurosawa DJ, Osuchowski MF, Valentine C, Kurosawa S, Remick DG. The pathogenesis of sepsis. Annu Rev Pathol. 2011;6:19-48.

Rivers EP, McIntyre L, Morro DC, Rivers KK. Early and innovative interventions for severe sepsis and septic shock: taking advantage of a window of opportunity. CMAJ. 2005;173(9):1054-65.

Tullo G, Candelli M, Gasparrini I, Micci S, Franceschi F. Ultrasound in Sepsis and Septic Shock—From Diagnosis to Treatment. J Clin Med. 2023;1185:1-11.

Chavez MA, Shams N, Ellington LE, Naithani N, Gilman RH, Steinhoff MC, et al. Lung ultrasound for the diagnosis of pneumonia in adults: a systematic review and meta-analysis. Respir Res. 2014;15(1):50.

Staub LJ, Mazzali Biscaro RR, Kaszubowski E, Maurici R. Lung Ultrasound for the Emergency Diagnosis of Pneumonia, Acute Heart Failure, and Exacerbations of Chronic Obstructive Pulmonary Disease/Asthma in Adults: A Systematic Review and Meta-analysis. J Emerg Med. 2019;56(1):53-69.

Lichtenstein DA. BLUE-Protocol and FALLS-Protocol. Chest. 2015;147:1659-70.

Leopold SJ, Ghose A, Plewes KA, Mazumder S, Pisani L, Kingston HWF, et al. Point-of-care lung ultrasound for the detection of pulmonary manifestations of malaria and sepsis: An observational study. PLoS One. 2018;13(12):e0204832.

Lichtenstein D. Lung ultrasound in the critically ill. Curr Opin Crit Care. 2014;20:315-22.

Dreger NM, Degener S, Ahmad-Nejad P, Wöbker G, Roth S. Urosepsis--Etiology, Diagnosis, and Treatment. Dtsch Arztebl Int. 2015;112(49):837-47.

Gans SL, Pols MA, Stoker J, Boermeester MA; expert steering group. Guideline for the diagnostic pathway in patients with acute abdominal pain. Dig Surg. 2015;32(1):23-31.

Kimura Y, Takada T, Kawarada Y, Nimura Y, Hirata K, Sekimoto M, et al. Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg. 2007;14(1):15-26.

Pötter-Lang S, Ba-Ssalamah A, Bastati N, Messner A, Kristic A, Ambros R, et al. Modern imaging of cholangitis. Br J Radiol. 2021;94(1125):20210417.

Shoemaker WC, Appel PL, Kram HB, Waxman K, Lee TS. Prospective trial of supranormal values of survivors as therapeutic goals in high-risk surgical patients. Chest. 1988;94:1176-86.

Kern JW, Shoemaker WC. Meta-analysis of hemodynamic optimization in highrisk patients. Crit Care Med. 2002;30:1686-92.

Practice parameters for hemodynamic support of sepsis in adult patients in sepsis. Task Force of the American College of Critical Care Medicine, Society of Critical Care Medicine. Crit Care Med. 1999;27:639-60.

Hollenberg SM, Ahrens TS, Annane D, Astiz ME, Chalfin DB, Dasta JF, et al. Practice parameters for hemodynamic support of sepsis in adult patients: 2004 update. Crit Care Med. 2004;32:1928-48.

Bennett SR. Sepsis in the intensive care unit. Surgery. 2015;33:11:565-71.

Annane D, Bellissant E, Bollaert PE, Briegel J, Keh D, Kupfer Y. Corticosteroids for treating severe sepsis and septic shock. Cochrane Database Syst Rev. 2004;(1):CD002243.

Sprung CL, Annane D, Keh D, Moreno R, Singer M, Freivogel K, et al. Hydrocortisone therapy for patients with septic shock. N Engl J Med. 2008;358(2):111-24.

The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000;342:1301-8.

Goeschel CA. Nursing leadership at the crossroads: evidence-based practice ‘Matching Michigan-minimizing catheter related blood stream infections’. Nurs Crit Care. 2011;16:36-43.

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Published

2024-06-25

How to Cite

Reshi, M. R., Nabi, N., Muzaffar, M., Anees, S., Yusuf, N., Qasim, A., & Naqvi, M. (2024). Septic shock diagnosis and its treatment. International Journal of Basic & Clinical Pharmacology, 13(4), 551–557. https://doi.org/10.18203/2319-2003.ijbcp20241658

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Section

Review Articles