Septic Shock

Septic Shock

occurs in setting of serious systemic infections

n

gram negative bacteria, gram positive bacteria

n

release endotoxins into the circulation

n

>50% have bacteria present in blood (bacteremia)

.

n

most common in elderly or immunocompromised

n

lung, abdomen, urinary tract most common sources

n

endotoxins lead to production of cytokines

n

IL-1, TNF-a

n

nitric oxide

n

powerful vasodilator (dilates the blood vessel)

nhallmark is ¯¯ vascular tone (and \¯ SVR)

n compensatory responses
n
- increased HR in attempt to preserve cardiac output
n
- often, myocardial function depressed
n
- endotoxins, lactic acidosis as a result of sepsis