Sepsis

José Manuel Ramos Rincón, Spain

From: Salud (About Health)
PABLO PÉREZ MARTÍNEZ, JOSÉ MANUEL RAMOS RINCÓN, ANA MAESTRE PEIRÓ

Sepsis is a reaction of the body to an infection caused by microorganisms such as bacteria, viruses and even fungi. When our defenses are not able to eliminate the infection by microorganisms or their toxins, we react by producing substances such as interleukins, which spread through the bloodstream, causing a generalized inflammatory reaction in the body to the infection.

Sepsis is a medical emergency and if not diagnosed and treated early, it can be life-threatening, leading to irreversible tissue damage, septic shock, and multiple organ failure.

This extreme reaction of the body to an infection especially affects vital organs such as the brain, lungs, liver, kidneys, etc., which are damaged; this is what we know as sepsis. Therefore, sepsis is not a disease in itself, but arises when there is a poorly regulated response of the body to an infection that damages the person’s own tissues and organs and threatens the person’s life.

If there is no timely intervention and there is significant damage to multiple organs so that they stop functioning, the patient’s life is in danger. We call this critical phase septic shock.

The symptoms of sepsis may initially go unnoticed or are mistaken for those of a normal infection. That is why we must be very vigilant in people susceptible to developing this complication (the elderly, diabetics, immunosuppressed patients or people with serious chronic pathologies).

The most common infections that trigger sepsis are:

Respiratory tract infections.
Gastrointestinal and biliary infections. Urinary tract infections.

Attention must be paid to certain signs and symptoms that should alert you to possible sepsis and that are a reason for urgent medical consultation. These are:

A temperature above 38°C or below 36°C, accompanied by an increase in heart rate to more than 95 beats (or beats).
Increased breathing rate to more than 24 breaths or shortness of breath.
Low blood pressure.
Nausea or vomiting.
Decreased urine volume.
Tendency to sleep, confused state, and altered consciousness, especially in older people.

Comunicar Salud
(Health Communications)

PABLO PÉREZ MARTÍNEZ, JOSÉ MANUEL RAMOS RINCÓN, ANA MAESTRE PEIRÓ

1ª edición: febrero 2023
© Sociedad Española de Medicina Interna
ISBN: 978-84-09-47805-7
eISBN: 978-84-09-48195-8

This is a Spanish book full of short articles on a wide range of diseases and clinical conditions written for lay people and patients by various authors.

The book contains useful information and it has been made available in English to serve European readers by the courtesy of SEMI, the Spanish Society of Internal Medicine, in cooperation with FDIME. We will publish chapters as short reports regularly over the coming months.

We hope you will enjoy reading them.

10 key points

Sepsis is a medical emergency and if not diagnosed and treated early, it can lead to irreversible tissue damage, septic shock or multiple organ failure, and be life-threatening.
Each year, approximately 31 million people suffer an episode of sepsis.
Sepsis goes unnoticed or is misdiagnosed in its first manifestations when it could still be treated effectively.
Sepsis Code has demonstrated significant reductions in mortality based on the general guidelines of the “Surviving Sepsis” campaigns.
The qSOFA* scale comprises the following criteria: tachypnea (respiratory rate >21 rpm/min), altered level of consciousness (Glasgow scale assessment <15 points) and hypotension (systolic blood pressure ≤100 mmHg). An alteration of two or more of these criteria is indicative of septic process.
Sepsis can be considered a relevant and growing public health problem due to its high incidence and related high mortality.
Of those who suffer from sepsis, about 6 million die from it.
The “Surviving Sepsis” campaigns have reduced mortality related to severe sepsis and septic shock to below 25%.
The Quick SOFA score (qSOFA)* allows the identification of sepsis in health centers and emergency departments without performing laboratory tests.
In the hospital it is performed the assessment of the SOFA (Sequential Organ Failure Assessment)* for a correct description of dysfunction/failure of different organs and, therefore, for the definition of multiorgan failure.

* The qSOFA (quick Sequential Organ Failure Assessment) score is a simple score consisting of three items, it includes 1 point for each of 3 criteria: (1) respiratory rate ≥ 22 breaths/min, (2) altered mental status or (3) systolic blood pressure (SBP) ≤ 100 mm Hg. A qSOFA score ≥ 2 is suggestive of sepsis. Septic shock is defined by the need for a vasopressor to maintain a patient’s mean arterial pressure (MAP) ≥ 65 mmHg and serum lactate level ≥ 2 mmol/L (2023 update).