Medical Health Information

Action

Treatment

The treatment of septic shock which controls the patient in intensive care, is directly dependent on the cause. For example, adrenocortical insufficiency requires a very specific treatment.

It is first necessary to fulfill the patient's circulatory system (vascular filling) by implementing infusions of saline, natural colloids such as albumin or synthetic colloids such as gelatin or dextran.

It must then maintain ventilation by creating up oxygen nasal catheter or mask, intubation or assisted respiration.

Injection of dopamine or other catecholamines ensures vessel tone (vascular tone).
Broad-spectrum antibiotics and specific function of the initial outbreak are urgently needed. Early administration of this antibiotic should be awaiting the results of susceptibility testing. Most often it is gentamicin or tobramycin as well as third-generation cephalosporins are used.

The treatment of renal failure is sometimes useful as the cause of septic shock.
In case of severe sepsis, some teams specialized in resuscitation, and intensive care used recombinant human activated protein C (Xigris drotrecogin or laboratories Lilly).

Evolution of the disease

Oliguria can monitor the aggravation of septic shock.
The prognosis of septic shock is not good. It depends on many factors, most of the germ and the door. For instance, sepsis whose starting point is lung or skin seemed serious is that whose starting point is urinary gastroenterology (gallbladder and intestine). When bacteremia persists, especially in the case of an immunocompromised patient, the prognosis is even worse.

Complications of the disease

The cardiac and respiratory failure and the emergence of a progressive coma may complicate septic shock.

Abscess inside the body is called metastatic suppurative location are possible in certain organs such as the lungs and pleura, the meninges, endocardium, liver, kidneys and bones but also joints.

Several organs can be affected by both the metastatic abscesses.

Septic shock: Causes

These are mainly Gram-positive infections are the most frequent fewer frequently encountered Gram-negative infections and fungal (mushrooms). The facilitative conditions include diabetes, cirrhosis, LPDs and additional tests performed with the patient (invasive procedures).

The introduction of intravascular catheter and other equipment (positioned within a vessel) are increasingly responsible for occurrence of toxic shock.

Immunocompromised individuals (decrease defense capabilities an individual) are more willing to make toxic shock, especially Gram-negative.

Medical specialties most often involved in sepsis and septic shock are (list not exhaustive):

Gastroenterology is particularly certain conditions such as occlusions, cancer, diverticulitis, abscesses and perforation. In this case, the causative organisms are enterococci, E. coli, Klebsiella, Bacteroides, enterobacteria, Salmonella and Aeromonas hydrophila.

Urology and especially catheterization, indwelling catheters, cystoscopy obstructions the causative organisms are E. coli, Klebsiella, enterobacteria.
Gynecology and obstetrics with particular interventions on the uterus (curettage, abortion, instrumentation, post-partum). The causative organisms are E. coli gonococcus, streptococcus, Bacteroides, Klebsiella.

Interventions on the skin and mucous membranes and specifically interventions after trauma and extensive burns and sometimes less large-scale.

Cardiology and interventions on the heart and veins, especially with catheterization, artificial heart valves, pacemakers, intravenous infusion with contaminated solutions. The causative organisms are Klebsiella, Pseudomonas aeruginosa and Acinetobacter.

Pulmonology, and in particular, interventions on the bronchi and lungs. It is essentially the tracheotomy, obstructions and ventilation. The causative organisms are pneumococcus, Pseudomonas aeruginosa, Hemophilus, Klebsiella, Acinetobacter Baumann, Enterobacteriaceae, Escherichia coli and Proteus.

The hematology (leukemia, agranulocytosis). The causative organisms are staphylococci, Pseudomonas aeruginosa and Acinetobacter Baumann.

Septic shock: Symptoms

Symptoms of septic shock are:
Hypotension (low blood pressure) occurring in a patient acutely febrile (temperature> 38.5 °), but sometimes a patient hypodermic, that is to say, having a body temperature below normal (

Septic shock: Classification
Fulminant meningococcal septicemia due to extreme growth of meningococci in blood. These bacteria release endotoxin that causes the appearance of an elevated temperature, vomiting, fall in blood pressure, which evolves towards a collapse, that is to say, an impossibility for the principal organs to ensure their function (septic shock). In addition, there are cyanosis (blue-violet skin and integument) and cutaneous purpura. Purpura, in some patients is also present in the viscera (the disease is then called purpura meningococcal bracket. Patient has at this point prostration very important. Often associated with this disease, meningitis is the rule.

Toxic shock syndrome (TSS Toxic Shock Syndrome) is a set of symptoms caused by an exotoxin (TSST-1) occurring in children and women in the menstrual period, women who use tampons. The action of the buffer is to promote the growth of staphylococci.

This type of condition is also found in respiratory Staphylococcus aureus complicating influenza.

Table of septic shock, but it is followed within 48 hours of an eruption resembling scarlet fever and erythematous form of generalizing to the entire body. This eruption is followed by desquamation (loss of small scales of skin) occurring at the palm of the hand and soles of the feet at the end of three days a week.

Blood culture, that is to say, the search is negative germs and isolation of Staphylococcus aureus is from the initial focus manager (when it is possible to find it). The evolution of this infection is to the patient's death in 10-15% of cases due to ventricular fibrillation (inability of the heart to provide effective contractions to eject blood through the circulatory system) that leads to a refractory hypoxemia (inadequate tissue oxygenation curable or incurable difficult).
This disease should not be confused with Kawasaki syndrome.

Septic shock: Medical tests

• Laboratory tests can reveal metabolic acidosis, disseminated intravascular coagulation, a decrease as the number of platelets (thrombocytopenia), signs of renal failure occur gradually due to acute tubular necrosis.
• Determination of white blood cell count with seeking immature
• Determination of platelets (decrease frequent).
• Determination of azotemia.
• Determination of creatinine.
• Cortisol is elevated in septic shock.

Septic shock in the abrupt decrease in blood flow in response to chills accompanied by hyperthermia (elevated temperature) due to a bacterial infection, mainly by bacteria identified by Gram-staining.

Infectious or septic shock is the result from the presence in the blood of bacterial toxins. Which leads to inadequate cardiac function (systolic blood pressure less than 90 mg of mercury) is characterized by tachycardia (rapid heartbeat), a tachypnea (rapid breathing), oliguria (decreased amount of urine eliminated) and metabolic acidosis (decrease in pH of the body), all occurring in a subject febrile (temperature is greater than 38, nine ° centigrade).

The term sepsis is the set of symptoms due to the repetitive discharge and quantity of seed having the ability to cause disease. These discharges are doing inside the blood from a focus of infection. Sepsis is characterized by general symptoms such as fever and chills.

The term is used to describe toxemia all symptoms are due to the presence of toxins bacterial in nature without the bacteria invade the bloodstream.

The term refers to the presence bacteremia, transient bacteria from the blood without this resulting in the appearance of signs (temperature, etc.....) And this during a disease that is localized.

The systemic inflammatory response syndrome, for specialists in infectious disease, is a group of symptoms that occur during infections (septic shock) and other conditions such as severe trauma, extensive burns or pancreatitis acute. This type of syndrome is characterized by the presence of a temperature from above 38 ° Centigrade, or otherwise

Sinus tachycardia: Definition

Heart rhythm disorder characterized by the presence of tachycardia, that is to say, a normal increase in heart rate (also called sinus rhythm). This increase in heart rate does not exceed or rarely 150 beats per minute.

This definition sinus tachycardia for adults only.

The heart beats normally at a rate between 60 and 80 beats per minute, which corresponds to a rhythm called sinus rhythm. The term comes from sinus, which is a small area of  the myocardium (heart muscle) located at the right atrium. This location is also called the sinus node or sinoatrial (named after two British researchers Arthur Keith and Martin Flack, which discovered it). Its role is to ensure control of heart rate. It is a set of small and highly specialized muscle cells located in the wall of the right atrium. At this point, is the start of the electrical pulse that will be used to make the heart beat: the pulse delivered by the sinoatrial node causes contractions of the heart chambers. Sinus tachycardia has a beginning and an end progressive.

Sinus tachycardia: Causes

This is actually a cardiac response in case of:

• Fever
• In hypovolemia (amount of blood in the body than normal
• On Anxiety
• In efforts
• Disorders of the thyroid gland
• In hypoxia or anoxia (lack of oxygen to the blood from the lungs)
• On hypotension
• In heart failure (malfunction of the heart pumped as such)

Sometimes it is secondary to physiological causes said that is normal to say:

• Effort physique
• Emotion
• Digestion
• Praised drugs such as atropine, vasodilators (drugs to enlarge the caliber of blood vessels), neuroleptics, antidepressants, thyroid hormones.

Coffee, strong tea, alcohol and tobacco are also likely to accelerate the heart rate.

Sinus tachycardia: Symptoms
Sinus tachycardia has one minute to  change of pace (there called paroxysmal tachycardia others, which are usually regular, which means that their rhythm is always the same). Sinus tachycardia is slowed by the supine position.

Sinus tachycardia: Consultation doctor
A test (Valsalva test) causes slow sinus tachycardia. This test consists of compressing the finger's carotid arteries (arteries from each side of the neck). This operation should never be performed by someone other than the doctor. Indeed, the slowdown it causes can cause cardiac arrest.

Sinus tachycardia: Medical Examination
The electrocardiogram showed the presence of atrial P wave and normal conduction time between the atria and the ventricles.

Sinus Tachycardia: Treatment
Sinus tachycardias should not be treated as arrhythmia (arrhythmia). Indeed, they represent an additional demand of the body requiring increased work of the heart to increase the amount of blood reaching the organs and tissues and therefore, treatment should be that of the cause. If it is heart failure, the treatment will appeal to a drug based digitalis or diuretics (drugs for the patient to urinate). It may also be an oxygen, which comprises using oxygen in case of hypoxia, that is to say, when the amount of oxygen reaching the tissues in is inadequate. In case of fever, prescription medication with aspirin is sufficient, provided that the fever does not reflect a major infection. Anxiety can be treated by taking tranquilizers beginning if possible using valerian as gentle molecules associated or not with hawthorn, to monitor the emotional state.