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Septic Shock
Septic Shock
DISTRIBUTIVE SHOCK
Definition
- type of shock result of loss of vasomotor control (vascular tone),
resulting artheriolar and venular vasodilatation and
maldistribution of bood flow (coexistence of hypoperfusion and
hyperperfusion areas ).
FORMS
– Septic shock
– Anaphylactic shock
– Neurogenic shock
– Endocrine shock
– Toxic shock
– Traumatic shock without hypovolemia
SEPTIC SHOCK
Septic shock is the most severe form of infection.
CONTINUUM OF SEVERITY
CONTINUUM OF SEVERITY
Hypovolemic ↑ ↓ ↓ ↓ ↓ ↑ ↑ ↓
shock
Cardiogenic ↑ ↓↓ ↓ ↑ ↑ ↑ ↑ ↓
shock
Septic shock ↑ ↓ N ↑ ↓N N ↓ ↓ ↑
SEPTIC SHOCK
TREATMENT PRINCIPLES
SURVIVING SEPSIS CAMPAIGN – 2004
1. Initial resuscitation (first 6 hours):
• CVP 8-12mmHg
• Mean TA >65mmHg
• SvO2> 70%
• Urine output >0,5ml/kg /h
2. Cultures:
• Blood cultures
• Cultures from the suspected phatologycal product
3. Antibiotic therapy
• Early (in the first hour after recognition of septic shock)
• Empirical – broad spectrum, active on suspected pathogens
• Association of antibiotics ; large doses; intravenous administration, adapted to
pharmacokinetic
• at 48 hours– deescalation therapy
4. Controling the source of infection
• Surgical procedure for eradication of the source of infection
SEPTIC SHOCK
TREATMENT PRINCIPLES