Sepsis or septicemia is a serious medical condition in which the overwhelming and automatic response of the body toward an infection leads to inflammation of the body parts, tissue damage, and organ failure.
This disease is often difficult to diagnose and develops into severe sepsis and septic shock over time, if not treated properly.
Sepsis or septicaemia is a life-threatening illness. Presence of numerous bacteria in the blood, causes the body to respond in organ dysfunction. Image Credit: Designua / Shutterstock
Sepsis is considered as a medical emergency. Studies show that with every hour that passes without giving treatment for sepsis, the risk of death increases by 7.6%. Therefore, a person who is identified with sepsis should be provided with rapid treatment.
Three main actions are basically followed to treat a person confirmed with sepsis. They are as follows:
1. Rapid stabilization
Admitting the person into intensive care unit (ICU) is the first thing that should be done. Steps for reversing life-threatening abnormalities such as problems in breathing and circulation should be taken care of and monitoring of vital signs such as blood pressure, heart rate, respiratory rate, and temperature should be done in correct intervals.
Mechanical ventilation can be given to the patient who has developed severe sepsis or septic shock. Such patients may face difficulty in breathing and thus, they are provided with incubation with the help of a tube attached to the ventilator. Through nasal cannula or mask, the patients are given oxygen so that the availability of enough oxygen can be ensured.
Devices Used in Monitoring Patients Include;
- Arterial lines: An arterial line is inserted into an artery of the patient to get samples of blood from an artery rather than taking it from a vein. This helps in providing better care and is also used for monitoring the blood pressure.
- PreSep Oximetry Catheter: In the ICU, this type of catheter is used to monitor the levels of oxygen in the blood that runs through the heart.
- Pulmonary artery catheter: This catheter is inserted into the pulmonary artery and is used to monitor the blood that passes from the heart to the lungs where the blood gets oxygenated.
2. Immediate Clearance of Mmicroorganisms from Blood
- Antimicrobial drugs are administered to patients for immediate and early clearance of microorganisms from the blood, so that the chance of developing septic shock as well as death can be lowered. Depending on the source of infection, the antimicrobial agents prescribed will change. Sometimes, more than one type of antibiotics is prescribed by the doctor based on the nature of infections. Initially, broad-spectrum antibiotics are used as they can be effective against various bacteria with common features. Administration of these drugs is mostly done intravenous (IV), as they enter the bloodstream quickly and function efficiently.
- Administration of IV fluids is another important step to be taken, as antibiotics alone cannot treat sepsis. For such patients, there is a high chance of the blood pressure dropping, which will put him/her into septic shock. To prevent this kind of a situation, extra fluids are administered to the patient, which also allows the doctor to keep track of the fluid given and control it, depending on the situation. Adequate body fluids are necessary for the organs to work properly, in turn reducing the damage that can be caused due to sepsis. Among the various IV fluids available, some are regularly used in the treatment of sepsis, for example, normal saline and colloids like albumin or dextran.Normal saline is a crystalloid fluid containing minerals that easily get dissolved in water, while colloids are thicker and do not dissolve as quickly as crystalloids. Crystalloids are less expensive, but compared with colloids, the amount of crystalloids needed to stabilize a patient is higher.
Central Venous Catheter or center line is one of the equipment used in the ICU to give fluids and antibiotics by IV. It is a flexible tube that is inserted into the arms or the chest, which makes the work easier.
3. Focusing on infections and treating them
After completing the first two steps, when the patient is stabilized, treatment for the specific infections can be started. This step includes three stages, depending on the severity of the condition.
The stages are as follows:
- removal of foreign bodies;
- cleaning or draining of infected pussy exudate;
- removing infected organs and damaged tissues in severe cases (especially in septic shock).
Other Medications and Treatment
Since each patient is different and so are the causes, all available treatments may not be right for everyone. Thus, individual observation and treatment of root causes and infections of the patient should be done.
A few other medications/methods that are used are as follows:
- Corticosteroids: These are used to reduce inflammation as well as control the immune system by depressing it and making it less active. However, this does not always work for all patients and even doctors do not know the reason for it.
- Vasopressors: This is prescribed for patients with septic shock who have a very low blood pressure. By tightening the blood vessels, vasopressors force the blood pressure to increase.
- Kidney dialysis: Renal replacement therapy or kidney dialysis is done if necessary for patients whose kidneys fail to filter blood toxins.
Reviewed by Afsaneh Khetrapal BSc (Hons)