Septic Shock

Abstract

Septic shock is characterized by bacteremia and/or toxemia and hypotension. It is commonly a nosocomial disease that is the leading cause of death in intensive care units in the United States. The disease can result in profound cardiovascular instability, and it can also result in a syndrome of multiple system organ dysfunction. Death can also result from progressive hypotension (due to either a severe decrease in cardiac performance or a severe decrease in systemic vascular resistance) or patient demise can occur due to multiple organ system failure, a syndrome that can result in failure of lungs, kidneys, brain, liver, or heart. This disease probably results from the ability of microorganisms to cause the release of a number of mediators that have profound effects on microvasculature, myocardium, and perhaps other tissues. This is a systemic disease and every organ system may be affected. Despite the availability of effective antibiotics that can eradicate most of the infecting microorganisms, the mediators released cause enough damage to result in a high patient mortality. Although current therapy of this syndrome (with cardiovascular support and antimicrobial agents) has resulted in increased patient survival, future emphasis must be placed on characterizing and ultimately reversing the effects of the potent vasoactive circulating mediators of this disease.