Sepsis - Blood poisoning

Sepsis is the body's derailed response to an infection, where life-threatening disturbances occur in the functioning of organs. This derailed reaction occurs when bacteria or other germs or their toxins end up in the bloodstream or release so many inflammatory substances that a massive inflammatory reaction starts in the blood.

 

What normally happens in an inflamed finger, happens on (far too) large scale in the whole body. The inflammatory response becomes 'overheated' and therefore causes damage to the body. Lungs, kidneys, heart, brain or liver are at risk of falling out.
 
Oxygen deficiency occurs, blood vessels can leak, blood clotting gets disrupted and blood pressure can drop dangerously. If, in the latter case, this does not improve with the administration of a lot of fluid and special blood pressure-increasing medicines have to be used, we speak of a 'septic shock'.
 
Admission to the Intensive Care department is then required. In all cases, even without IC admission, a sepsis is life-threatening. The sooner the diagnosis is made and the treatment is started, the greater the chance of survival.
 

Possible symptoms of sepsis

  • Slurred speech
  • Acute confusion or altered consciousness
  • Extreme chills or muscle pain
  • Abdominal pain
  • Not urinating or urinating very little/no or little urine output
  • Feeling very ill, feeling like they are dying. The person appears very ill
  • Ashen, pale, or mottled (marbled) skin
  • Shortness of breath or rapid breathing (≥ 22/min = more than 22 breaths per minute at rest)
  • Rapid heart rate (more than 90 beats per minute at rest)
  • Fever (higher than 38°C) or a low body temperature (lower than 36°C)
  • Drop in blood pressure (systolic blood pressure ≤ 100 mmHg)
  • Eventually, vital organ failure may occur
 
The brain has a hard time during a sepsis. An expression of this is, for example, the delirium. This is the occurrence of acute confusion. Many people experience cognitive consequences in their recovery from a sepsis, for example problems with memory, concentration and divinding attention.
 

More information

 

PICS

In addition to cognitive symptoms caused by brain damage, symptoms can also arise from Post-Intensive Care Syndrome (PICS). New or worsening symptoms may arise as a result of critical illness and intensive care treatment.

 

Physical symptoms (fatigue, acquired muscle weakness, swallowing difficulties, loss of fitness, shortness of breath)

Cognitive symptoms

Psychological problems (anxiety, PTSD, depression)

Partners, family members, and other close relatives can also develop PICS, which is called Post-Intensive Care Syndrome Family, or PICS-F.

 

More information on PICS an PICSF can be found here.

 

 

Septic Shock

Septic shock is a life-threatening medical condition resulting from a severe infection that affects the entire body.
It is an extreme immune system response to an infection, in which bacteria, fungi, or viruses spread through the bloodstream and cause an inflammatory reaction.
This leads to a dangerous drop in blood pressure and can damage vital organs such as the heart, kidneys, and brain.
Symptoms of septic shock include a rapid heart rate, high or low body temperature, confusion, and difficulty breathing. It is a medical emergency requiring immediate treatment, often with antibiotics, intravenous fluids, and intensive care.

Resources

This Dutch page of which this page is a tranlation was written by in collaboration with 'sepsis en daarna

https://www.henw.org/artikelen/sepsis-herkennen-bij-een-volwassene

 

Relevant information:

Angus DC, Van der Poll T. Severe sepsis and septic shock. N Engl J Med 2013;369:840-51.

Bakker J, Levi M, Van Hout BA, Van Gestel A. Sepsis, een gecompliceerd syndroom met belangrijke medische en maatschappelijke consequenties. NedTijdschr Geneeskd. 2004; 48):975-8.

McPherson D, Griffiths C, Williams M, Baker A, Klodawski E, Jacobson B, et al. Sepsis-associated mortality in England: an analysis of multiple cause ofdeath data from 2001 to 2010. BMJ Open. 2013;3. pii: e002586.

Iwashyna TJ, Ely EW, Smith DM, Langa KM. Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA.2010;304):1787-94.

Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the criticaldeterminan

Nasa P, Juneja D, Singh O. Severe sepsis and septic shock in the elderly: An overview. World J Crit Care Med 2012;1:23-30.

Vincent JL. The clinical challenge of sepsis identification and monitoring. PLoS Med 2016;13:e1002022.