Early Recognition and Diagnosis of Septic Shock

Early Recognition and Diagnosis of Septic Shock

• Other physiological signs of poor organ perfusion can serve as historical indicators of low blood flow or predictors of discharge with an arrhythmic event.
• Acute kidney injury, characterized by a creatinine level >2 mg/dL, is a key indicator of poor organ perfusion.
• Progression to septic shock is associated with an in-hospital mortality ranging from 12.5% to 49.7%.
• It is essential to differentiate between community-acquired septic shock, healthcare-acquired septic shock, and hospital-acquired septic shock, as the causative bacteria may differ.
• Identifying the bacteria causing the septic shock informs the choice of empirical broad-spectrum antibiotic therapy.
• Recent treatment with antibiotics, such as amoxicillin or macrolides, may have eradicated vaginal bacterial anaerobes, leading to gut dysbiosis and bacteremias.

Diagnostic Criteria for Septic Shock

• Septic shock diagnosis requires recognition of systemic infection and clinical signs of substantial tissue perfusion abnormalities.
• The American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) diagnostic criteria for septic shock, known as 'Sepsis-2', include:
  • Acute organ dysfunction
  • Hypotension (systolic arterial pressure <90 mmHg or a decrease of ≥40 mmHg from baseline)
  • Additional clinical or laboratory evidence of acute organ dysfunction

Recognize physiological signs of poor organ perfusion as indicators of low blood flow or prognosis for arrhythmic events, and understand the implications for in-hospital mortality. Learn to identify community-acquired septic shock.