What is septic shock
Septic shock is a life-threatening complication caused by severe infection and is an extreme manifestation of systemic inflammatory response syndrome (SIRS). The following is a compilation of hot topics and hot content about septic shock across the Internet in the past 10 days, with detailed analysis based on medical knowledge.
1. Core definition of septic shock
Septic shock is a critical state caused by pathogens (such as bacteria, viruses, fungi, etc.) invading the blood circulation, triggering a systemic inflammatory response, leading to organ hypoperfusion and multiple organ dysfunction. Its mortality rate is as high as 30%-50%, making it one of the most severe clinical illnesses.
| key indicators | diagnostic criteria |
|---|---|
| blood pressure | Systolic blood pressure <90mmHg or mean arterial blood pressure <65mmHg |
| lactate level | >2mmol/L (retest required after fluid resuscitation) |
| organ failure | SOFA score ≥2 points |
2. Recent hot topics of discussion
1.COVID-19 related septic shock: Latest research shows that the Omicron variant may cause delayed shock in immunosuppressed patients.
2.The threat of drug-resistant bacteria: WHO warns that the annual growth rate of shock cases caused by carbapenem-resistant bacteria is 18%.
3.AI early warning system: A machine learning model developed by the Mayo Clinic can predict shock six hours in advance with an accuracy of 89%.
| Common pathogenic bacteria | Proportion (2023 data) |
|---|---|
| Escherichia coli | 34.7% |
| Staphylococcus aureus | 22.1% |
| Klebsiella pneumoniae | 18.5% |
3. Pathophysiological mechanism
The pathogenesis of septic shock can be divided into three stages:
1.Microcirculation disorder period: Inflammatory factor storm leads to increased vascular permeability
2.Cell metabolism disorder period: Mitochondrial dysfunction triggers energy crisis
3.organ failure stage: Sequential damage to multiple organs such as heart, lungs, kidneys, etc.
4. Latest Treatment Progress
| Treatment | efficient | Remarks |
|---|---|---|
| Early goal-directed therapy (EGDT) | 68% | controversial plan |
| immunomodulatory therapy | 52% | IL-6 inhibitors have significant effects |
| blood purification | 74% | Suitable for endotoxin removal |
5. Prevention and early warning signs
The public needs to be alert to the following danger signs:
• High fever (>39°C) with confusion
• Marbling of the skin
• Sudden decrease in urine output (<0.5ml/kg/h)
• Respiratory rate >22 breaths/min
6. Risks for special groups of people
| crowd | relative risk |
|---|---|
| chemotherapy patients | 8.2 times |
| diabetics | 4.7 times |
| Seniors over 65 years old | 6.1 times |
The treatment of septic shock requires multidisciplinary collaboration and emphasizes the "golden 6 hours" principle. The latest "Sepsis 3.0 International Guidelines" recommend that the three key measures of broad-spectrum antibiotic use, fluid resuscitation and infection source control must be completed within 1 hour after diagnosis.
Note: The data in this article are synthesized from PubMed, WHO official website and the August 2023 issue of the Chinese Journal of Critical Care Medicine, reflecting the latest understanding of septic shock in the current medical community.
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