Treating Sepsis
Understanding Sepsis and Its Treatment
When you have an infection, your immune system sends white blood cells to fight it, causing swelling and inflammation. Inflammation is good in small areas for a short time because it helps your body heal.
But when it spreads throughout your body, inflammation damages tissues and interferes with blood flow. Your blood pressure drops, injuring organs. This reaction is called sepsis. If not treated promptly, sepsis can rapidly lead to shock, multiple organ failure, and death.
Sepsis is a life-threatening condition, but with prompt treatment, most people survive.
Being in the ICU
If you have severe sepsis, you will be cared for in the intensive care unit (ICU). Your care team may include an intensivist — a doctor specializing in critical illness — nursing staff with advanced skills, and specialists.
What is sepsis
Sepsis is an infection that is often bacterial, but can also be viral or fungal. The body’s immune system overreacts to the infection, causing widespread inflammation and organ damage. Sepsis can progress through stages: sepsis, severe sepsis, and septic shock. Sepsis symptoms vary but can include fever, chills, confusion, rapid breathing and heart rate, changes in mental status, and extreme pain.
If sepsis progresses to septic shock, symptoms can include an inability to stand, not being able to stay awake, and extreme confusion. Septic shock also causes a severe drop in blood pressure.
If you or someone you know experiences these symptoms, seek immediate medical attention. Early diagnosis and treatment with antibiotics, fluids, and other support medications are crucial for survival.
Antibiotics
Intravenous antibiotics are the first choice to treat sepsis. The type of antibiotic given will depend on where the infection started and what organism is causing it.
Usually, because the specific organism isn't known immediately and prompt treatment is critical, your doctor will start you on a broad-spectrum antibiotic that treats many kinds of organisms and switch to a more specific antibiotic later.
Your doctor may change your treatment to oral antibiotics after several days, depending on your condition. It is critical to continue taking them for the complete prescription to eliminate the infection. Don’t stop taking your medication just because you feel better.
Intravenous Fluids
With sepsis, inflammation causes fluid to move from your blood vessels to your tissues, creating swelling and impairing healthy blood flow. This causes your blood pressure to drop.
If this happens, you will receive intravenous fluids to raise your blood pressure. Fluids also can protect your kidneys and prevent kidney failure. Your kidneys are sensitive organs and need a steady blood supply to function.
Blood Pressure
If your blood pressure does not rise with IV fluids, you may need medication. Your team will give you these medications intravenously and monitor you carefully. Your doctor will place a thin tube called an arterial line into an artery to check your blood pressure continuously.
Organ Support
Sepsis can affect how your organs work, and they may need help to continue functioning. If multiple organs are affected, there are limited options for treatment, and you are less likely to survive. Getting help early is the best way to prevent multiple organ failure.
Lungs. Your body needs more oxygen when you have sepsis. You may get oxygen through a small tube in your nose or a face mask. If you have difficulty taking breaths, you may need breathing support. A ventilator is a machine that can assist you in breathing through a tube placed in your throat.
Kidneys. If your kidneys stop making urine, you may need dialysis. Dialysis replaces what your kidneys do by removing extra fluid, balancing the electrolytes in your blood, and removing toxins. A nurse performs dialysis using a specialized intravenous line. You can have dialysis intermittently, like every other day, or continuously for several days.
Heart. As sepsis worsens, your heart might not be able to get the blood it needs to work properly. Medication may be used to help.
Other Treatments
Due to the severity of sepsis, your doctor may use additional treatments to help you.
Insulin. Insulin lowers blood sugar. Even if you don't have diabetes, your blood sugar can spike with a severe infection.
Steroids. You may receive corticosteroids, orally or intravenously, to decrease inflammation.
Blood. You may need a blood transfusion if your blood counts are low. A transfusion can also help your blood pressure.
After Sepsis
Sepsis is hard on your body. Some people experience long-term effects. Post-sepsis syndrome includes limb swelling, fatigue, joint pain, muscle weakness, and chest pain. These symptoms can last for months or years.
Being in bed for a long time also causes you to lose muscle strength. A rehabilitation program can help you regain strength.
Talk to your doctor about your post-sepsis recovery plan.
Resources:
What is Sepsis? Centers for Disease Control.
Surviving Sepsis Campaign Guidelines 2021. Society for Critical Care Medicine.
How is sepsis diagnosed and treated? Centers for Disease Control.
Recent advances in understanding and managing sepsis. F1000 Research.
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