What Are the Criteria for Septic Shock?

Septic shock is a severe and often deadly condition caused by an exaggerated immune response to an infection. According to the Merck Manual, the average fatality rate is about 40 percent. Prompt treatment is critical to ensuring survival; consequently, it's important that medical professionals recognize the signs and symptoms of septic shock.

Sepsis/Septic Shock

• Cells in your body release signals in response to an infection that trigger an immune response. Among your immune system's defenses is inflammation; usually the body regulates this response. In some cases, however, the immune system's reaction quickly spirals out of control, especially if large numbers of bacteria are circulating in the bloodstream. The inflammatory response--rather than being localized to a particular site--extends throughout your entire body, a condition called sepsis. Blood flow to various organs may be impaired, causing eventual organ failure and death. Septic shock is basically sepsis at a more advanced stage.

Diagnostic Criteria

• Septic shock is the most advanced form of sepsis. Generally doctors want to identify sepsis as soon as possible so they can treat it before it progresses to this later stage. Doctors distinguish between sepsis, severe sepsis and septic shock using several criteria. A patient who is suffering from septic shock exhibits low blood pressure in addition to the signs of both sepsis and severe sepsis.

Sepsis

• A patient is diagnosed with sepsis if she exhibits at least two of the four common symptoms: Her temperature exceeds 101.3 degrees Fahrenheit or dips below 95 degrees, her heart rate is faster than 90 beats per minute, their breathing rate is greater than 20 breaths per minute and she has an infection.

Severe Sepsis

• If a patient exhibits at least two of the symptoms of sepsis and at least one sign of severe sepsis, he will be diagnosed with severe sepsis instead. Symptoms of the severe stage include oliguria (decreased urine output), hypoxemia (low partial pressure of oxygen in the blood), low platelet count, trouble breathing, areas of mottled skin or a sudden change in mental state or condition. If the patient also exhibits low blood pressure, he is generally diagnosed with septic shock.

Other Factors

• Nausea, vomiting, hyperventilation, confusion and high fever are all signs that suggest possible sepsis in a patient with an infection. Other common signs include increased levels of blood urea nitrogen or creatinine, decreasing volume and osmolarity (the concentration of dissolved substances) of urine and abnormal heartbeat. Septic shock most often occurs in the very old, the very young or patients whose immune systems are compromised or who are suffering from a chronic illness. Early diagnosis and treatment are the best countermeasures. If you have a question about your condition (or that of a loved one), the best person to consult for advice is your doctor.