What Is the Pathophysiology of Sepsis?

Septic shock is also called septic shock or toxic shock. It is a microcirculation disorder caused by pathogenic microorganisms and their toxins in the human body, causing hypoxia, metabolic disorders, cell damage and even multiple organ failure. Adults, infants and young children, chronic diseases, chronic malnutrition, immune dysfunction and patients with malignant tumors or patients after major surgery are particularly prone to occur.

Septic shock

Septic shock is also called septic shock or toxic shock. It is a microcirculation disorder caused by pathogenic microorganisms and their toxins in the human body, causing hypoxia, metabolic disorders, cell damage and even multiple organ failure. Adults, infants and young children, chronic diseases, chronic malnutrition, immune dysfunction and patients with malignant tumors or patients after major surgery are particularly prone to occur.

The pathogenesis of septic shock is extremely complex, and research has reached the cellular, sub-microstructure, and molecular levels. When the body's resistance is reduced, pathogens that invade the body or normally inhabited in the body can multiply, release their toxic products, and use it as a motive to activate human body fluids and cell-mediated response systems to produce various inflammatory mediators and bioactive substances The plexus causes a series of pathophysiological changes in the body, which causes dramatic changes in hemodynamics, leading to circulatory failure.

Early shock: High chills and fever, individual severe patients may show a decrease in body temperature, normal blood pressure or slightly lower blood pressure, but a small pulse pressure difference, pale, cold skin, arterial spasm on fundus examination, mild cyanosis of the lips, Consciousness but irritability, deep and fast breathing, decreased urine output, and some patients may present with warm shock in the early stages.

Middle shock: mainly manifested as hypotension and acidosis.

Late shock: DIC and multiple organ failure can occur.

DIC is manifested as intractable hypotension and extensive bleeding, and there are manifestations of multiple organ dysfunction or failure.

Acute cardiac insufficiency: sudden increase in breathing, cyanosis. Fast heart rate, dull heart sounds, and arrhythmia. The ECG shows changes in myocardial damage, heart rhythm disturbances, and conduction blocks.

Acute renal failure: a significant decrease in urine output or anuria, and a fixed proportion of urine. Increased blood urea nitrogen and blood potassium.

Shock lung: manifested by progressive dyspnea and cyanosis, which cannot be relieved by oxygen inhalation.

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Hematology: Most white blood cell counts increased, and neutrophils increased with toxic particles and left shift of the nucleus.

Urine: Urine routinely can have a small amount of protein, red blood cells and casts.

Etiological examination: blood, cerebrospinal fluid, urine, stool, and purulent lesion exudate were taken for culture before antibiotics were applied, and those with positive cultures were tested for drug sensitivity. The lysate test is helpful for the detection of trace endotoxins.

Blood gas analysis: Arterial blood pH is high in the early stages of shock.

Blood biochemical examination.

DIC detection indicators: mainly check platelet count, prothrombin time. Fibrinogen quantification, plasma protamine paracoagulation test, Euglobulin dissolution time, thrombin clotting time.

The treatment of shock should be comprehensive, and the primary disease should be actively treated. At the same time, blood volume should be supplemented according to the pathophysiology of shock, acidosis should be corrected, vasomotor function adjusted, erythrocyte agglutination prevented, microcirculation stasis, and important organs maintained. Functions.

Treatment of primary disease: infection should be actively and quickly controlled. The principle of using antibiotics is: select strong, broad antibacterial spectrum, sensitive to pathogenic microorganisms, large doses, combined use, in order to reduce the symptoms of poisoning, under effective antibacterial treatment, a large number of adrenocortical hormones are used for a short time.

Anti-shock treatment.

Replenish blood volume.

Correct acidosis.

Prevent microcirculation stagnation.

Maintain the function of important organs.

Prevention and treatment of cardiac insufficiency.

Maintenance and prevention of lung function.

Maintenance of renal function.

Prevention and treatment of cerebral edema.

Treatment of DIC.

Application of adrenal corticosteroids.