On-Call Advice

Sepsis is a potentially life-threatening complication arising from infection in the body. The condition occurs when the body attempts to fight an infection by releasing chemicals into the bloodstream that cause an overwhelming inflammatory response throughout the body. This inflammation can lead to tissue damage, organ failure and death. 

Typical signs that sepsis is starting to occur include rapid heart rate and breathing, fever, chills, or disorientation—particularly if any of these signs is accompanied by a known or suspected infection. As sepsis becomes more severe, the affected person typically experiences one or more signs of organ failure, such as decreased urine production, decreased platelet count, sudden changes in mental status, abnormal respiration or circulatory problems. People who go into septic shock often exhibit dangerously low blood pressure that does not respond readily to fluid-replacement therapy. 

Diagnosing sepsis can be difficult because many of its symptoms also occur with other illnesses. Blood tests; analysis of other bodily fluids such as urine, sputum and wound secretions; and imaging studies such as ultrasound, CT or MRI may be used to pinpoint the type and source of the infection that is causing the sepsis. 

Treatment typically involves use of broad-spectrum antibiotics to fight infection, vasopressors to raise blood pressure, and other medications such as corticosteroids and insulin. Supportive therapy may include oxygen and large amounts of intravenous fluids. In some cases, patients may require respirators or dialysis. 

Sepsis is most common and most dangerous in older people, those with compromised or suppressed immune systems, and people with wounds or burns. It often occurs in hospitalized patients—particularly those in intensive care units who may have breathing tubes or intravenous catheters. 

Most people with early or mild sepsis recover, but the death rate of those with septic shock is approximately 40-50 percent. As the U.S. population ages, healthcare providers are seeing an increasing incidence of sepsis, and with that in mind, hospitals are working to implement effective preventive measures and to raise awareness among providers to help ensure that effective treatment begins in the early, milder stages of the disease. 

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