什麼是膿毒綜合徵 (感染性休克)

膿毒症是與感染潛在的致命的病症. 發生膿毒症時排入血液中的化學物質在整個身體對抗感染觸發炎症反應. 這種炎症可以引起變化的白內障,可損害多個器官系統造成他們失敗. 如果敗血症進入敗血性休克, 血壓下降生動地壩,並可能導致死亡.

任何人都可以開發敗血症; it is most prevalent and most dangerous in older adults or those with weakened immune systems. Early treatment of spies, normally with antibiotics and large ma=ounts of intravenous fluids, improves chances for survival.

症狀
Many doctors view sepsis as a three -stage syndrome, starting with spicy and progressing through critical/server sepsis to septic shock. The goal is to treat sepsis throughout its early stage before it grows more serious.

膿血症
To be diagnosed with sepsis, you must present a least two of the following symptoms plus a probable or confirmed infection.
Body temperature above 101 (38.3 C) or below 96.8F (36 C)
Heart rate higher than 90 跳動一分鐘
respiratory rate higher than breaths a minute
Severe Sepsis
Your diagnosis will be updated to severe sepsis if you also exhibit a treat on of the following signs and symptoms, which may mean an organ is failing.

  • Abrupt change in mental status
  • Decreased in platelet count
  • Difficult breathing
  • Abdominal pain
  • Abnormal heart pumping function
  • Significantly decreased urine output
  • Septic shock

To be diagnosed with septic shock, you must have the indications and symptoms of sepsisplus extremely low blood pressure that doesn’t doesn’t adequately respond to simple fluid replacement.

當去看醫生
Most often sepsis transpires in people who are hospitalized. People in the intensive care unit are particularly vulnerable to acquiring infections, which can then produce sepsis. If you get an infection or if you produce signs and symptoms of sepsis after surgery hospitalization or a virus, seek medical care promptly.
原因

  • While any infectionbacterial, viral or fungalcan commence the growth sepsis, the most likely varieties include:
  • 肺炎
  • Kidney infection
  • Bloodstream infection Bacteremia
  • Abdominal infection
  • The incidence of sepsis appears to be growing in the united states in the United States. The causes of this increase may include.
  • Aging population. American are living longer, so the increase in the senior population or those over 65 is growing.
  • Drug -resistant bacteria, Many types of bacteria can resist the effects of antibiotics that once killed them. These antibiotic-resistant bacteria are often the cause of infections that trigger sepsis.
  • Weakened immune systems. More people around the world are living with weakened immune systems created by HIV, cancer treatments or transplant drugs.

風險因素

  • Sepsis is more common and more critical if you:
  • Gave a minor used number stored
    Are already very, often in a hospital’s intensive care units
  • Have wounds or injuries, such as b
  • Are very young or old
  • Have invasion devices, such as intravenous catheters or breathing tubes.

並發症

Sepis ranges from less to more less to more severe. As sepsis worsens, blood flow to essential organs, such as our brain heart and kidneys, become impaired. Sepsis can also cause blood clots to develop in your organs and your arms, legs finger and toes, leading to varying degrees of organ failure and tissue death (壞疽).
Most people recover from mild sepsis, but the mortality rate for septic shock is nearly 50 百分. 也, an episode of severe speeds may place you at higher risk of future infections.

診斷

Diagnosing Sepsis sepsis can be difficult because it signs and symptoms can be other disorders. Doctors often order a battery of test o trying to pinpoint the underlying infection.

驗血
A sample of your blood should be withdrawn from two different sites and tested for:

  • Evidence of infection
  • Abnormal liver or kind function
  • Clotting problems
  • Impaired oxygen availability
  • Electrolyte imbalances

Other laboratory tests
Depending on your symptoms, your physician may also want to test on one of the following bodily fluids:
Urine . If your physician assumes that you have a urinary tract infection. He or she may want your urine checked for signs of bacteria.
Wound secretion if you have a wound that appears infected, testing a sample of the wounds secretions can assist in showing what type of antibiotic might work best.
Respiratory secretionsIF you are coughing up mucus (spit) it may be tested to conclude what type of germ is causing the infection.
Imaging scans
If the site of infection is not clear, your doctor may order one or more of the listed imaging test.

Imaging scans
If the site of infection is not obvious, your order one or more of the following imaging test:
X0ray Using how levels or radiation, X -rays are good for visualizing problems in your lungs
計算機斷層掃描 (CT) contaminations in your appendix, pancreas or bowels are clearer to see on CT scans. This technology takes X-rays from several angles and combines them to depict cross -section slices of your body’s internal organs.
Ultrasound -This technology uses sound waves to produce real-time images on a video monitor. Ultrasounds may be especially useful to check for contaminations in your gallbladder or ovaries
Magnetic resonance imaging MRI MRIs may be helpful identifying soft tissue infection s, such as abscess within your spin, This technology use radio waves and a strong magnet to produce cross 0sectional images of your internal structures.

治療
Early, aggressive treatment helps boost your chances of surviving sepsis. Individuals with severe sepsis require close evaluation and treatment in a hospital intensive care unit. If you have severe sepsis or septic shock, the life-saving measure may be required to stabilize breathing and heart functions.

藥物治療
Some medications are used in treating specs. 他們包括:
抗生素 – Treatment with antibiotics should begin immediately within the first six hours of earlier, 原來, receive broad spectrum antitoxins with are effective against a variety of bacteria. The antibiotics are administered intravenously. (IV). After leaving the results of blood test. Your doctor may recommend a different antibiotic that more appropriate toward the particular bacteria causing the infection.
Vasopressors. If your blood pressure persists to be too low even after obtaining intravenous fluids, you may be given a vasopressor medication, which compresses blood vessels and helps to increase blood pressure.
Other medications you may receive include low doses of Corticortirords, insulin to help support stable blood sugar levels, drugs that modify the immune system systems responses, and painkiller or sedatives.
Supportive Care
People with severe sepsis normally receive supportive care including oxygen and generous volumes of intravenous fluids. Depending on your condition, you may need to have a device helps help you breathe or another machine to provide dialysis for kidney failure
手術
Surgery may be needed to remove sources of infection, such a collections of pus (abscesses)