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Sepsis Syndrome and Septic Shock

Sepsis syndrome is the body's response to a serious, life-threatening infection or inflammatory process. Often this response is induced by bacterial infections in which the organism has gotten into the systemic blood circulation. These patients may present with high fever, though they may also have hypothermia (abnormally low temperature). They often appear ill with a high respiratory rate, low blood pressure, and a fast heart rate. When the blood pressure drops below a critical value (less than 90 mm Hg systolic), or if vital organs receive inadequate oxygen delivery, the condition is then called septic shock.

The general approach to treating patients with sepsis and septic shock includes aggressive supportive therapy, intravenous fluids, oxygen therapy, vasopressors (medications to elevate the blood pressure in cases were the blood pressure is abnormally low), and antibiotics to treat any infection that may be causing this systemic inflammatory response. Additionally, any focus of infection (such as an abscess) may require surgical drainage. In approximately 35% of patients, bacteria is isolated from the blood stream and antibiotics can be targeted to this particular organism. In other cases, groups of organisms are suspected and often multiple antibiotics are used to ensure any occult bacterial infection is treated.

The development of novel alternative therapies for sepsis syndrome is an exciting area in critical care research today. Many new agents are being tried to blunt the body's inflammatory response until the infection can be adequately treated. Critical care physicians are hopeful that in the next few years our current research endeavors will help improve patient outcome in this very serious disorder.

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