Sepsis

Sepsis is the leading cause of death in American hospitals. It is a life-threatening medical emergency in which the body’s response to an infection becomes dysregulated and begins damaging its own tissues and organs. Sepsis can progress rapidly, and it is important to seek immediate treatment. Delays in treatment increase the risk of organ failure or septic shock, which carries a high risk of death. Early recognition, timely treatment and advocacy by patients and families are essential to saving lives and improving recovery from sepsis.

Sepsis occurs when the body’s immune response to an infection becomes uncontrolled and begins damaging organs. It can develop from common infections, such as pneumonia, UTIs or skin infections. When the body’s immune system reacts abnormally to the infection, the response spreads through the bloodstream, triggering widespread inflammation that can disrupt blood flow, lower blood pressure and reduce the amount of oxygen reaching vital organs like the brain, kidneys, heart and lungs. This uncontrolled response leads to sepsis, and if untreated, organ damage and shock.

Sepsis often begins with subtle and nonspecific symptoms and can be difficult to recognize early but can progress rapidly. Time is critical in treating sepsis. Studies show every hour treatment is delayed significantly increases the risk of death

Sepsis is classified into 2 main categories, sepsis and septic shock. Both sepsis and septic shock are medical emergencies and patients should seek immediate treatment.

The progression from sepsis to septic shock can happen quickly, sometimes within hours.

Symptoms of sepsis can vary from person to person but often include a combination of infection signs and organ dysfunction.

Common symptoms include:

• Fever, shivering or feeling very cold
• High heart rate or weak pulse
• Rapid or shallow breathing
• Extreme fatigue or weakness

Worsening symptoms include:

• Confusion, disorientation or difficulty thinking clearly
• Shortness of breath or increased need of oxygen
• Low blood pressure or lightheadedness
• Little or no urine output
• Severe body pain or discomfort
• Pale, cool, clammy or bluish skin

There is no single test that definitively diagnoses sepsis. Sepsis is suspected when a patient has a known or suspected infection along with organ dysfunction, such as confusion, breathing difficulty or mental status changes. Lab tests, cultures and imaging can help to determine the source of infection.

Sepsis and septic shock are medical emergencies. Treatment usually begins immediately, often before a definitive diagnosis. Early sepsis treatment can stop progression to septic shock. Sepsis treatment includes:

• Rapid antibiotics
• IV fluids
• Oxygen and breathing support
• Monitoring and lab tests
• Treatment of the infection (draining abscesses, surgery if needed)

Septic shock requires aggressive, ICU-level care including sepsis treatment plus:

• Vasopressor medications to increase blood pressure and delivery of oxygen to the body
• Advanced ICU support including ventilation or dialysis
• Continued antibiotics and source control