Sepsis

The sepsis , although for many it is an unknown disease, the truth is that it is a disease that is as deadly as myocardial infarction . Clinically known as systemic inflammatory response syndrome, it is a serious condition in which there is a systemic inflammatory response of the body to a certain infection.

Sepsis causes around 1,400 deaths a day globally ; a figure very similar to that of other diseases such as heart attack or stroke.

Detecting the disease early and establishing the appropriate treatment for it are two key factors for patient survival.

What is it?

Sepsis is an inflammatory response of the body as a defense against a serious infection , which is usually caused by bacteria; however, it can also be caused by other types of microorganisms such as fungi or viruses.

It is a life-threatening condition in about 33% of the cases presented as blood clots form that interrupt the flow to vital organs.

Sepsis can present itself in the following ways.

• Bacteremia: the presence of bacteria in the blood is known as such. It is not a type of sepsis itself, but it is a fundamental requirement for it to take place.
• SIRS: it is a general inflammation that occurs due to an infection; It can also occur as a consequence of various processes such as hemorrhage or trauma. The most common symptoms are fever , higher than usual heart and respiratory rate, and leukocytosis .
• Severe sepsis: this is a more serious typology of the disease than the previous case. Blood circulation decreases in certain areas of the body; thus, patients present hypotension and less urine.
• Septic shock: this is the most serious type of sepsis, with very low blood pressure. The risk of mortality is very high.

Causes of sepsis

The microorganisms that cause sepsis can enter the bloodstream from a wide selection of routes. Regarding the most frequent external routes, they are the focus of infection and the injection of said microorganisms into the blood . Regarding the internal pathways, the patient ‘s own flora stands out , which can generate viruses and bacteria that give rise to this condition. Of course, sometimes the route of entry is not known.

It is important to note that the fact that the microorganism comes into contact with the bloodstream does not necessarily imply that it will cause sepsis. It depends on a large selection of factors: more or less aggressiveness of the virus, bacteria or fungus; number of microorganisms; health status of patients in relation to their immune system …

In relation to the microorganisms that most frequently cause sepsis, they are bacteria ; viruses, fungi and parasites are far less common.

Infection focus

The main cause of this disease, which occurs in a high percentage of patients, is a specific source of infection: respiratory tract, infected tissues … Sepsis is very common in Intensive Care Units ; It is estimated that 40% of patients admitted to these areas develop sepsis of greater or lesser severity.

Flora and contact with blood

On certain occasions, sepsis develops from the patients’ own flora; microorganisms that are generally found in areas such as the throat or skin . Viruses or bacteria can also come into contact with the bloodstream from the outside; contaminated blood transfusions, use of contaminated syringes in cases of drug addicted patients …

Symptoms of sepsis

It is important to pay special attention to the symptoms of sepsis. As we have pointed out, diagnosing and treating this condition in its initial phase significantly increases the chances of survival. When sepsis occurs, different organs of the body can be affected , so that the clinical picture varies greatly from one patient to another. Here are some of the signs that occur in most cases.

• Fever: practically 100% of patients with sepsis have a body temperature above 38ºC.
• Cardiovascular system: one of the most common manifestations of sepsis is tachycardia; that is, a heart rate greater than 100 beats per minute.
• Brain: sepsis affects to a greater extent those people with weakened immune systems , such as the elderly. Thus, in this type of patient symptoms such as confusion or alteration are frequent.
• Blood: sepsis is caused by the infection of a microorganism, so it is usual for the number of white blood cells to increase. In a blood test, patients also present a reduction in the number of platelets.
• Kidney: This is a disease that affects all organs, including the kidney. Sepsis decreases the amount of blood that the heart pumps to the kidney, so its function is impaired; as a result, the amount of urine is significantly reduced.
• Digestive system : This disease often causes damage to the liver. Thus, one of the symptoms that occurs when this organ is affected is jaundice .
• Skin: in relation to the skin, sepsis causes from cold to skin eruptions of all kinds.

Diagnosis and treatment

In relation to the diagnosis of sepsis, it is important to know that until now , no analytical test is known to allow a definitive diagnosis of this disease .

The doctor should request both a blood and urine test . In addition, depending on the symptoms that patients present, he may be suspicious of where the source of the infection is and request a laboratory culture.

Sepsis is a serious disorder , so it is essential to treat it as soon as possible. There is no specific treatment or drug to treat this disease, so from a medical point of view it can only be managed globally to patients to increase the chances of survival. This management consists of three phases.

Monitoring

Patients must remain admitted and monitored , so that their vital signs are recorded continuously: blood pressure, amount of oxygen in the blood, respiratory rate and heart rate.

Medium

Supportive treatment is essential so that patients do not suffer from hypertension or hypotension, for which different intravenous serums are administered . In addition, they are treated with oxygen therapy in those cases in which the volume of oxygen in the blood is low.

Cause

Sepsis develops from a certain infection, so a fundamental phase of treatment is to treat it. To do this, the most common is to administer intravenous antibiotics .

In cases of sepsis, both the evolution of the patients and the prognosis largely depend on the period of time that elapses between the appearance of the first symptoms and the start of treatment. If it is not diagnosed in time, the evolution to septic shock can occur very quickly, thus causing the death of patients.

Complications of sepsis

Sepsis has a very rapid evolution since it spreads rapidly through the bloodstream , so it can lead to extremely serious complications. In just a few hours, organs as important as the lungs or the heart can be affected, and fail. Thus, if there is a circulatory shock or kidney failure or lung or liver failure, the mortality rate exceeds 60%.