In people's daily lives, various diseases often occur, so shock is still familiar to people. However, because shock covers many types, in order to fully understand the symptoms of the disease, it is necessary to have a certain understanding of septic shock. The following article provides a popular science on septic shock.
In clinical practice, septic shock is a type of shock that is difficult to treat and commonly seen in surgery. In fact, the disease is caused by multiple pathogenic microorganisms entering the human body, leading to severe release of inflammatory mediators and infection, which in turn promotes peripheral circulation expansion, ultimately resulting in insufficient effective circulating blood volume. In addition, the disease is mostly secondary to a type of Gram negative bacterial infection with severe release of endotoxins, such as urinary tract infections, biliary tract infections, acute peritoneal infections, etc., also known as endotoxin shock. In clinical practice, septic shock mainly includes two hemodynamic types, namely high dynamic septic shock and low dynamic septic shock. Low power type is characterized by microcirculation stasis, peripheral vascular constriction, and excessive leakage of capillaries, leading to a decrease in CO and blood volume. After the onset of the disease, the patient's skin becomes relatively damp and cold, also known as cold shock. The high-power type exhibits reduced resistance, peripheral blood vessel dilation, and increased opening of arteriovenous short circuits, abnormal blood flow distribution, and cellular metabolic disorders. After the onset of the disease, the patient's skin is relatively dry and warm, also known as warm shock.
From the perspective of hemodynamics, septic shock belongs to distributed shock; However, from the perspective of infection, septic shock is a serious manifestation of Sepsis. In fact, most patients, especially hospitalized patients, are at risk of infection. And if the patient has a more severe primary disease, the probability of infection will also be higher. And if the patient develops an infection, it may form a causal relationship with the primary disease, that is, Sepsis becomes a common pathway for disease progression. This condition is a fatal organ dysfunction caused by an imbalance in the body's response due to infection. septic shock is a severe type of Sepsis and therefore has a high mortality rate. So, how to treat septic shock clinically?
Firstly, control the infection. During the treatment process, it is necessary to make reasonable choices of antibiotics and antibiotics based on the different primary infections. For patients whose pathogens have not yet been identified, it is necessary to select antibiotics or apply broad-spectrum antibiotics based on clinical judgment of the most likely pathogen to cause the disease. If necessary, surgery may be performed to promptly remove the sepsis lesion.
Secondly, replenish blood volume. Shock can cause obvious symptoms of insufficient blood volume, and supplementing blood volume is the main measure during treatment. The main treatment method is infusion of balanced salt solution, combined with appropriate plasma, colloid solution, and whole blood, in order to timely restore the patient's circulating blood volume.
Thirdly, early use of cardiac glycoside drugs. When a patient experiences shock, it can reduce their own myocardial function. Therefore, early nutritional cardiotonic drugs can effectively prevent the occurrence of pulmonary edema and heart failure, and can also correct shock in a timely manner.
Fourth, use vasoactive drugs. When acidosis has not improved after correction and blood volume supplementation, it is necessary to use vasodilators in a timely manner, or in combination with alpha receptor agonists or vasoconstrictors with mild excitation of beta receptors.
Fifth, glucocorticoid drug therapy. When using glucocorticoids, they can inhibit the release of various inflammatory mediators and stabilize lysosomal membranes, thereby alleviating clinical septic shock.
Sixth, bundle therapy. According to national requirements, standardized bundle therapy measures are carried out. A specialized team for bundle therapy is composed of experienced medical personnel from departments such as emergency, infectious disease, laboratory, and critical care. Through joint consultation, a blood purification plan is developed for critically ill infected patients, and relevant data is collected through quality control to continuously optimize the bundle therapy plan. This ensures that patients with septic shock can complete the bundle therapy plan within 3 hours and 6 hours, safeguarding their life safety.