Septic Shock: Pathophysiology to Patient Care

Septic shock is a serious, complex, and life-threatening complication of sepsis that is characterized by fluid resistant hypotension and involves organ dysfunction caused by a dysregulated response to infection. At the tissue level, sepsis triggers a catastrophic inflammatory response ending up in endothelial damage, vascular dysfunction, and organ failure. The clinical picture of septic shock may comprise tachycardia, tachypnea, fever or hypothermia/chills, oliguria or anuria, declining Glasgow coma scale (GCS), severe body aches, multi-organ dysfunction, delayed CRT, and rash/ecchymosis. SIRS, qSOFA, and SOFA are some of the clinical scores aiding in diagnosing septic shock. Septic shock can rapidly progress to respiratory failure, cardiovascular compromise, multiorgan failure, and death. Mortality rates are exceptionally high, and survivors present with multi-organ dysfunction and neurological impairment. Prompt recognition and early and individualized aggressive treatment (fluid resuscitation, vasopressor support, broad spectrum antibiotics) and meticulous monitoring are the cornerstones of management.