Septic shock - causes, symptoms, treatment. septic shock

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The septic shock is borne before an important acceleration of the infection, as it is not without reason for the life of the people. When the perfusion of the tissue decreases, the acid goes through the price. As soon as you do not live through the entry, everything can end with a change internal organs, Death of the sick. The morbidity of the sick person is close to 50%. Often, septic shock is characteristic of young people, children, and immunodeficient ailments.

cause

Beastly your respect, septic shock is the most frequent provocation of pathogenic microflora:

Anaerobic and aerobic streptococcus.
Intestine stick.
Bacteroides.
Clostridia.
Beta-hemolytic streptococcus.
Klebsiella.
The second pathogenic microorganisms.

It means that Staphylococcus aureus and beta-hemolytic streptococcus virally exotoxin, which can lead to. Sepsis is a fiery appearance. If toxic speech appears in the blood, the viroblation of ignited cytokines is stimulated. Such a reaction is the cause of adhesion of leukocytes, neutrophils.

See septic shock

All lies because of the de-localization of pathology, as it does not. see:

Legeny-pleural view.
Peritoneal.
Intestine.
Biliarny.
Shkirny.
Ugly.
Obstetrician.
Shkirny.
Sudinniy.
Phlegmonous.

For this reason, as against pathology, you see:

Bliskavichny.
Progressive.
Sterty.
Early.
Thermal.
Recurrent.

symptoms

Signs to lie down from the zabudnik, as well as from the fact that in which country there is an immunity. Beastly your respect, there are often the following symptoms:

Turbulent chills.
The temperature appears to be the temperature.
It is not possible to detect hemorrhage, papular visipus.
A stepwise build-up intoxication to the body.
To appear.

Prior to nonspecific symptoms are:

Zbilshena spleenka, stove.
Chills.
Riska weakness.
Hypodynamia.
The style is broken (turbulent constipation).

As soon as antibacterial therapy is not carried out, everything will end with the destruction of robots and internal organs, with the death of a sick person. In case of septic shock, thrombosis, which leads to a hemorrhagic syndrome, is suspected.

Important! Antibacterial therapy gives the possibility of reducing intoxication. In case of septic shock with massive infection, gostrom ignition process, Initiative to develop. Of course, if polyarthritis is due to septic shock. For some ailments, it all ends with polyserositis, myocarditis, glomerulonephritis.

Prior to these symptoms, which occur during septic shock, are:

, X-rays may show pneumonia.
Septic abortion is especially not safe for a woman, because at a new day, the reaction in the mother is ignited. In this vipadku, the judges can fix themselves with blood clots, microbes, and gnarly masses. In a dozen hour, toxic anemia develops, the color of the shkiri changes. It is not safe if everything ends with great superficial necrosis.
Tachypnoe to develop through those that ruin the robot's heart, Sudin. In this vipadku, the frequency of dichannia increases.
Septic pneumonia є To reduce the frequency of accelerated sepsis.
The training of the pechinka. In case of sepsis, it is worthwhile to repair the stove, to appear strong beat in the battles, in the blood, the rivn of transaminazi, bilirubinu. In a dozen hour, the number of the outbound house will decrease. Everything will end with pechink deficiency.
Nirkovy stripe. If the grip falls sharply, the volume of blood falls, vinikak dyurez. The battle turns out to be low, depending on the heat. In nirkahs it is possible to take on an organic, functional expression of an organic character.
Bowel problems. Beastly your respect, sepsis supravodzhutsya intestinal paresis, important damage to the herbal process. In the intestine, a rotten process develops, it is guided by septic diarrhea, dysbacteriosis.
Trophic damage. If blood microcirculation breaks down, bedsores appear.
The spleen is getting better.

methods of treatment

Important intelligence, septic shock to finish overwhelming camp... In general, in the case of a sick person, an intensive therapy is carried out for him. Zvoryuvannya grows rapidly, it can lead to serious acceleration, death.

The therapy is guilty, but it is complex, it is necessary to invade the pathogenic flora, yak vede to pathology. The main method of elimination is the reception of antibiotics, anti-fatigues. Hormonal therapy is also required.

With a septic shotsi vikoristovuyutsya not less than two antibiotics, maє wide rangeдії. Whenever there is a specific visionary, it is recognized as antibiotics of antiinfectious diseases. All drugs should be administered parenterally - in the ointment or in the vein.

For an hour, the blood is taken continuously, in order to identify pathogenic microbes. Antibacterial therapy is trivial, as long as the bacterial infection is not negative.

To polishit the organism, to inject the ailing interferon, antistaphylococcal plasma. Corticosteroids should be consumed in an important way. It is especially important to establish immunity, so it is not difficult to become a doctor-immunologist.

Sometimes an operation is necessary, when you see dead tissue. Due to the fact that the ignition is de-localized, it is necessary to carry out the operation.

To fit organs in a normal stanza Norepinephrine, Dopamine Hydrochloride, Dobutamine, інші lykarski zasobi for normalization vice.

With such a rank, it is important to destroy everything, to get ahead of you. Septic shock is a camp, which is in the middle of a non-secret hospital, which also helps to detect the lack of internal organs.

Symptoms are often corrected for chills and include fever and hypotonia, oliguria and confusion of symptoms. can I spontaneously gosdra lack decal organs, such as legends, nirki and stove. Likuvannya - intensive infusion therapy, Antibiotics, surgical treatment of infections with necrotic tissues and pus, adaptable therapy, and some control of blood glucose levels and the introduction of corticosteroids.

Sepsis - infection. gostry pancreatitisі serious injury, Including opioids, may present with symptoms of sepsis. The ignition reaction, as a rule, manifests itself in two or more signs:

Temperature> 38 ° С abo<36 °С.
Heart rhythm> 90 beats / min.
Frequency response> 20 per chilina abo PaCO 2<32 мм рт.ст.
Number of leukocytes> 12x109 / l abo<4х109/л или >10% immature form.

However, in the current hour the manifestation of these criteria є if the transmission factor is not sufficient for setting a diagnosis.

An important sepsis is sepsis, which is supervised by signs of deficiency, taken to one organ. Heart-vascular deficiency, which, as a rule, manifests itself in hypotonia, and the deterioration of the disorder - hypoxemia.

Septic shock is an important sepsis with hypoperfusion and hypotonia, which is not absorbed by adequate intensive infusion therapy.

Causes septic shock

Septic shock occurs more often in newborns, patients over 35 years old, and vaginal women. Friendly factories include diabet; liver cirrhosis; leukopenia.

Pathophysiology of septic shock

The pathogenesis of septic shock is not associated with vaccinations. Ignition agents (for example, bacterial toxin) should be produced before the release of mediators, including the fluff necrosis factor and IL-1. Cytokines wick neutrophilic-endothepal-clitin adhesion, activate the mechanisms of laryngeal blood flow and produce microthrombi until confirmation. Smells also take vivilnennya of other mediators, including leukotrin, lipoxygenase, histamine, bradikinin, serotonin and IL-2. I have to resist the anti-firing mediators, such as IL-4 and IL-10, as a result of the mechanism of a vocal negative sound.

A collection of arteries and arteries are expanding, heart wikid, growing. Anyway, the heart wikid can change, if AT falls, and there are types of signs of shock.

Navigate to the stage of an advanced heart wikid, vasoactive mediators to produce before the blood flows to the capillary mine (rose-related defect). Capillaries vipadayut from tsy shuntuvannya order from capillary obstructions with microthrombi, which change delivery 02 and reduce vivedennya C02 and other non-consumed products. Hypoperfusion can lead to dysfunction.

Coagulopathy can develop through internal-vascular coagulation for the participation of the main factors in the larynx of blood, strengthened by fibrinolysis, and often a combination of both.

Symptoms and signs of septic shock

In patients with sepsis, as a rule, they mean: fever, tachycardia and tachypnea; AT appears to be normal. Also call the presence of the signs of infection. First I will acquaint, both important sepsis, and septic shock, may be the confusion of evidence. AT zzvychay padaє, ale yak tse is not paradoxical, the shkіra will become warm. Oliguria (<0,5 мл/кг/ч). Органная недостаточность приводит к появлению определенных дополнительных симптомов.

Diagnosis of septic shock

Sepsis is suspected, if a patient develops systemic symptoms of an infectious disease with an infectious disease. If a sign of systemic inflamedness is evident, the ailment is guilty of but circumstances on the manifestation of infection. At the same time, it is necessary to obtain a medical history, medical examination and laboratory tests, including a laboratory analysis of a sech and a sech (especially in patients with permanent catheters), an organ culture for a healthy condition. With an important sepsis, procalcitonin and a C-reactive cell in the blood, it can be diagnosed, but the indicators are not specific. In the kintsevoy rakhunka, the diagnosis is primed on the clinic.

Some of the causes of shock (for example, hypovolemia, myocardial infarction) are responsible for the additional collection of anamnesis, medical examination, cardiograms and heart markers. Navigation without IM hypoperfusion can lead to the appearance of signs of ischemia on the cardiogram, including nonspecific ST-T imaging, inversion of T waves and supra-mucosa and supra-systoles.

Hyperventilation with mental alkalosis (low PaCO 2 and changes in blood pH) appears early, as compensation for metabolic acidosis. Syrovatkovy NSO; izvychay low, and the level of lactate of the blood of the blood. The shock progresses, metabolic acidosis goes down, and the pH of the blood decreases. Early deterioration of the reaction to lead to hypoxemia from Pa02<70 мм рт.ст. Уровень мочевины и креатинина обычно прогрессивно возрастают.

Practically, 50% of patients with important sepsis develop an apparent lack of supernatal corpuscles.

Vimіryuvannya hemodynamics can be victorious, if there is an unclear type of shock, or if a large amount is needed. Echocardiography (including through stravohidnu echocardiography) is the main method for assessing the functional status of the heart and the obviousness of vegetation.

Lіkuvannya septic shock

Infusion therapy with 0.9% physiological problems.
02-therapy.
Antibiotics of a wide range of diy.
Draining abscesses and visualization of necrotic tissues
Normalization of blood glucose level.
Corticosteroid therapy is substituted.

Patients with septic shock are guilty of being treated in an intensive therapy. Indications for continuous control of offensive parameters: systemic vice; CVP, Raor abo і those y іnshe; pulse oximetry; ABGs; blood glucose, lactate and electrolytes; function of nirok, i, possibly, sublingual PCO 2. Control of duresis.

If hypotonia is spared, it is possible to indicate dopamine, when the middle digit of the blood pressure is reduced, take up to 60 mm Hg. If the dose of dopamine changes is 20 mg / kg / hv, it can also be given a vasoconstrictor, usually norepinephrine. However, the buzzing of the sudin, in the presence of an increased dose of dopamine and norepinephrine, leads to the threat of organ hypoperfusion and acidosis.

02 is given as a mask. Intubation of the trachea and IVL can be necessary in case of impaired health.

Parenteral administration of antibiotics is guilty of being taken from blood and other mediums (ridin, tissue to the body) for sensitivity to antibiotics and seeds. An early empiric therapy, sending out inaccurately for sepsis susceptibility, is important and may be viral. The vibration of antibiotics is guilty of being primed, of primed on the transfer dzherel, on the key minds.

Scheme of therapy for septic shock of undesirable etiology: gentamicin or tobramicin, in combination with cephalosporins. In addition, ceftazidime can also be used in combination with fluorochinolones (for example, ciprofloxacin).

Vankomitsin is guilty of butti additions, as well as susceptible to resistant staphylococci or enterococci. Iakshcho dzherelo is localized in the middle of the empty space, it is necessary to include a drug in the therapy that is efficiently anaerobic (for example, metronidazole).

During therapy with corticosteroids, the dose should be changed rather than pharmacological. Scheme of storage of hydrocortisone in combination with fludrocortisone in case of hemodynamic instability and after 3 days.

Septic shock is an important factor in the reduction of infectious diseases, as it can clog the life of a sick person. Septic shock is characterized by a decrease in the perfusion of tissues, so I will clean the delivery of sour and lively words to the tissues. The Danish camp is made to the point of lack of internal organs, which is a deadly threat to a sick person. The immobility of a lethal result in a septic warehouse is 30 - 50%!

Most often, septic shock is restructuring in children, children who are sick with severe immune deficiencies.

Septic shock - cause and factor of development

Septic shock can also be caused by vicious pathogenic microorganisms. Bacteria that experience septic shock, as a rule, are classified as endotoxin-producing bacteria. Often the cause of septic shock is the onset of pathogenic microbes:

gut stick;
aerobic and anaerobic streptococci;
clostridia;
bacteroid;
beta-hemolytic streptococcus;
golden staphylococcus;
klebsiєlla;
іnshі pathogenic microorganisms.

Primitively, beta-hemolytic streptococcus and Staphylococcus aureus viroblyayut a specific bran exotoxin, which is a form of toxic shock syndrome in an ailing patient.

Septic shock (і sepsis) є as a fiery response to a critical factor. As a rule, it is a microbial endotoxin, and more - an exotoxin. Endotoxins are specific speeches (lipopolysaccharides), which are vivid during lysis (ruined) of gram-negative bacteria. Cytoxins activate specific immune mechanisms in human organisms, which lead to the development of the ignition process. Exotoxins are speeches, like gram-negative bacteria called.

Toxins are consumed in the roof and stimulate the circulation of ignited cytokines, middle ones: the necrosis factor of pukhlin, interleukin-1, interleukin-8 in the endothelium of sudin. Given the reaction to produce adhesion (adhesion) of neutrophils, leukocytes, endothelial cells with the approval of specific toxic substances.

Vidi zvoryuvannya: classification of septic shock

The classification of septic shock is based on the localization of pathology, especially the transition to the stage of compensation.

Septic shock is associated with the localization of the pathological process:

leg-pleural;
intestinal;
peritoneal;
biliarnym;
Urodynamic abo urinemic;
obstetric or hysterogenic;
shkirnim;
phlegmonous abo mesenchymal;
Suddenly.

Over the interruption, septic shock buvaє:

bliskavichnim (abo mittєvim);
early or progressive;
erase;
recurrent (abo septic shock with an intermediate stage);
thermal (abo piznim).

For the stage of compensation, septic shock is distributed on the onset of the following:

compensations;
subcompensations;
decompensations;
refractory.

Symptoms of septic shock: yak

Symptoms in septic shots are abundant in which to lie in the form of a pathogenic disease, to become a sick person's immunity and a penetration of infection.

An ear of septic shock can be consumed by burhlivim and supravodzhuvatisya such symptoms yak:

strong;
hemorrhagic or papular visip;
deeds, generally growing intoxication;
mіalgіya.

To frequent, ale nonspecific symptoms of sepsis can be caused by the following:

improvement of the spleen;
improvement of ovens;
Intense pithiness (with chills);
hypodynamia;
thinness;
collapse of style (as a rule, become constipated).

The rate of antibacterial therapy can be brought to a massive destruction of internal organs and the death of a sick person. In case of septic shock, thrombosis may occur, and you will experience hemorrhagic syndrome.

If, with a septic shock, a person is ill to carry out adequate antibacterial therapy, then the manifestation of intoxication will decrease after 2-4 times on the cob. On aphid septic shock, arthralgia develops through massive infection and ignition process. In important cases, a sick person may develop polyarthritis. Besides, on the other hand, I will have a lot of symptoms in glomerulonephritis, polyserositis and myocarditis.

Some of the other symptoms that occur with septic shock on aphids, є:

Symptoms of septic shock with important disseminated intravascular coagulation and respiratory distress syndrome. In this vypadku povyshliy development of the interstitial embryo, it will be more difficult for itself to appear polymorphic and disc-shaped atelectasis in the legends. Some changes in the legends are spared in the case of other important forms of septic shock. It is noteworthy that on the radiological signs of the image of the legends in mayzhe as well as in case of pneumonia.
Septic abortion. As a rule, with a septic abortion, bleeding is not infused, and there are some fragments of an ignition reaction in this case. As a rule, the judges are clogged with microbes, blood clots and blood visions from the house of masses. Potential development of toxic anemia and change in the barn-up of shkiri. In a sick person, petechial hemorrhages develop, which can be established on the mucous membrane, on the skin and on the internal organs. In deyaky vipadkah reach the establishment of great superficial necrosis.
Tachypnoe for septic shots. Through the deterioration of the activity of the heart-vascular system, a tachypic develops in a patient with septic shock. The frequency of the reaction can reach up to 40 vidhiv / vidihiv per chilina.
Septic pneumonia. Cement to often accelerate the septic process in the body.
Efficiency of the liver with septic shock. The pathology of the supernatant changes in the size of the liver. The stove is sick, and in the blood there is an increase in the level of transaminases, bilirubin. Decrease prothrombinovyindex, zagalnyy bilk and bilkovy fractions. Such a situation is to lead to the development of a guest's lack of pecuniary deficiencies with non-gated snakes.
Exercise nirok with septic shots. With a low decrease in the volume of circulating blood and a decrease in the arterial grip, it decreases and duresis. The cut is filled with low power and markers of the ignition process appear in them. In nirkakhs they have a functional and organic challenge, as they have a non-gate character.
Loss of intestinal motility. In case of septic shots, there is a lot of development of intestinal paresis and important damage to the intestinal tract. The intestines start a rotten process, there are septic infections and dysbacteriosis. Compensation for such damage is important.
Trophic damage. To reach early in case of septic shoots, bedsores are found. Winikak tse through the deterioration of microcirculation.
Zbilshena spleenka.

Patient's diy for septic shots

Septic shock є we will threaten the life with a camp. Intensely ill hospitalized and distributed intensive therapy. The ailment grows up to reach the speed, leading to the important and accelerating right up to the fatal result. It is important for him to deliver the sick person to the lykarna.

Diagnosis "septic shock" is displayed on the basis of characteristic symptoms, which develop during massive infectious process. Diagnosis is confirmed for the help of a series of laboratory and instrumental dosages.

In the first place, the septic shock is guilty of being a complex and vrahovuvati type of pathogenic flora, yak has wicked pathology. The main therapeutic approach for septic shots is massive antibacterial therapy, anti-apnea therapy and immunomodulatory therapy. Hormone therapy is also possible.

Antibacterial therapy. Massive antibacterial therapy of septic shock is guilty of supravigation of vicarious drugs, as there are minimal two antibacterial drugs of a wide spectrum of diy. Since it is a pathogenic source of visions and due to its sensitivity, then antibiotic therapy is carried out against specific infections. Antibiotics for septic shots are administered parenterally (into the vein, into the ointment, into the reionary artery or endolymphatic pathway).

When antibacterial therapy is carried out, blood is inoculated for the detection of pathogenic microbes on a regular basis. Antibiotic treatment can be carried out with a stretch of decal months, as long as the result of bacterial growth does not become negative and as long as the result of bacterial culture does not become negative or you do not achieve a stylish classy study.

Leukocyte suspension, interferon, hyperimmune anti-staphylococcal plasma can be introduced for the improvement of the organism of the sick person. In important cases, hormonal corticosteroids have been used. Corrections of immune disorders in case of septic shots should be carried out with a general consultation of a doctor-immunologist.

Khirurgichesky lykuvannya. The most important component in the treatment of septic shock Regardless of the localization of the business, there is a change in operative engagement.
Adopting therapy. To improve the health of the most important organs and systems, such preparations as hydrochloride dopamine, and other preparations, which produce a normal level of arterial clutch, are used. Masochny іngalyatsії sisnem is carried out to ensure proper oxygenation.

Deposition of septic shock

With a septic shock, the activity of large internal organs and systems is destroyed. The Danish camp will be overwhelmed with a fatal result.

Prevention of septic shock

Prevention of septic shock - tse come in, do not allow contamination of blood to grow. In case of septic shots, it is important not to allow the development of the lack of internal organs and the normal life of the patient's organism.

- a very important pathological camp, which is caused by the massive supply of bacterial endotoxins in the blood. Supervision of tissue hypoperfusion, critical lowering of the arterial grip and symptoms of multiple organ failure. Diagnosis is placed on the presentation of a foreign clinical picture, which, in its own right, is a sign of legends, heart-vascular system (CVS), liver and nirok, centralization of blood circulation. Likuvannya: massive antibiotic therapy, infusion of coloidal and crystalline breakdowns, improvement of the effectiveness of CVS for the treatment of the introduction of vasopressors, correction of respiratory breakdowns by means of a SHVL.

ICD-10

R57.2

Country houses

cause

In the absolute greater number of pathologies, the pathology develops on the basis of the weakening of immune reactions. Tse see children who suffer from chronic important illnesses, as well as people who have been kidnapped. Due to physiological peculiarities, sepsis is more often diagnosed in people. The list of the most widespread ailments, with which there may be an incidence of the ITSh, includes:

Infectious diseases. Signs of a systemic ignition reaction and damage associated with it in the robotic internal organs are indicated when there are large abscesses or phlegmon of soft tissues. The risk of a generalized toxic type of disease is observed with a trivial interruption of ailments, during the day of adequate antibacterial therapy and in a patient over 60 years of age.
Trivale perebuvannya in VRIT. The hospitalization for the diagnosis of reanimation and intensive therapy is linked to the diagnosis of sepsis and infectious shock. The price is accompanied by continuous contact with resistant to antibacterial drugs in microflora, weakening of the body's forces as a result of important ailments, the manifestation of many infections: catheters, drain probes, other tubes.
Rani. The deterioration of the integrity of the small curves, including the decrease in the hour of the operation, often increases the risk of the information being highly contacted by the flora. ITSh to be repaired by the ailments with wounds, who did not immediately take away the need for pre-morbidity. Traumatization of tissue in the course of operational involvement becomes the cause of generalized infection when the rules of asepsis and antiseptics are not followed. In a large group of patients, septic shock is diagnosed in patients who have transferred the manipulation to the slurry and the slurry. Another reason is broadened - diffuse peritonitis.
Acceptance of immunodepressants. Likarski zoobi, to bring immunity (mercaptopurine, kryzanol), vicorist to stifle the reaction in the process of organ transplantation. In the menshy world, the level of vlasy zhistu is reduced when they are implanted with chemotherapeutic agents - cytostatics, which are used for the treatment of cancer patients (doxorubicin, fluorouracil).
SNID. VIL-infection in the stage of SNID leads to development of atypical sepsis, caused by bacterial culture, and by a fungus of the genus Candida. Clinical manifestations of ailments are characterized by a small degree of turn. The presence of adequate immune responses allows pathogenic flora to proliferate.

The cause of sepsis is gram-positive (streptococcus, staphylococcus, enterococcus) and gram-negative (Enterobacter cloacae, Clostridium pneumoniae) bacteria. In the case of the bagatech culture, they are insensitive to antibiotics, which are quicker in the development of patients. The septic shock of the viral walk in the Danish hour of the week Some representatives of the scientific community are responsible for the fact that the virus is the cause of the pathology, and that the postulate form of life can provoke a systemic ignition reaction, as it is the pathogenetic basis of the ITS.

pathogenesis

Symptoms are based on uncontrolled expansion of mediators from pathological diagnostics. At the same time, there is an activation of macrophages, lymphocytes and neutrophils. Vinica syndrome of systemic ignition symptoms. The peripheral vascular tone decreases on a smallest decrease, the volume of circulating blood falls for the increase in the penetration of the sudin and the stagnation of the ridin in the microcirculatory bed. Subsequent changes to the increased perfusion changes. Lack of blood loss is the cause of hypoxia, ischemia of internal organs and deterioration of their functions. A very sensitive brain. Besides, the functional activity of the legends, nirok and stoves, will go down.

In case of formulated septic shock, the role of the development of endogenous intoxication is important. In connection with the decrease in the rate of excretory systems in the blood, the products of normal exchange of speech accumulate: creatine, sechovine, lactate, guanin and pyruvate. At the internal centers, there is a growing concentration of intermediate results of oxidation of lipids (skatole, aldehyde, ketones) and bacterial endotoxins. All the victories are important for homeostasis, the breakdown of the acid-puddle balance, the breakdown in the robot receptor systems.

Classification

The shock camp is classified according to the pathogenetic and clinical principle. Pathogenetic ailments can be "warm" and "cold". Warmth shock is characterized by an increase in the heart wikidum on the basis of a decrease in the lateral vascular tone, endogenous hypercatecholaminemia and enlarged internal vascular disease. The manifestations of organ deficiency rotate around the world. A cold type is manifested by a decrease in the heart wikid, a sharp weakening of tissue perfusion, centralization of blood circulation and important PON. Over the course of a critical interruption, septic shock will grow on the onset of the dream:

Compensation. The evidence is clear, intact, the ailment of falsifications, and more contact. The arterial grip is slightly reduced, the level of the CAT is not less than 90 mm of mercury. Tachycardia (PS<100 уд/мин). Субъективно пациент ощущает слабость, головокружение, головную боль и снижение мышечного тонуса.
Subcompensations. Shkira blida, drown the heart of the deaf, heart rate can reach 140 strokes in khvilina. GARDEN<90 мм. рт. ст., Дыхание учащенное, одышка до 25 движений/мин. Сознание спутанное, больной с задержкой отвечает на вопросы, плохо понимает, что происходит вокруг, где он находится. Речь тихая, медленная, неразборчивая.
Decompensations. Virazhene svidomostі. The patient will give a short message, often in 2-3 attempts. Rukhov's activity is practically daily, the reaction to the big is weak. The skin is cyanotic, covered with sticky cold sweat. Tony's heart is deaf, the pulse on the peripheral arteries does not appear abnormally weak. NPV up to 180 beats / hv, heart rate 25-30, dikhannya surface. AT lower than 70/40, anuria.
Thermal (non-gate). The privacy of the day, the shkіra of the marmurous vіdtіnku or sіr, including the bluish beaches. Dikhannya pathological according to the type of Biota or Kussmaul, NPV decrease up to 8-10 times / hviliya, and sometimes dichannya rises. SBP less than 50 mm Hg. stowpa. Seeing every day. The pulse was forced to palpate on the central vessels.

Symptoms of septic shock

One of the primary signs of the ITSh is arterial hypotonia. Renewal of the arterial vise does not come out with an adequate supply of infusion (20-40 ml / kg). To prepare hemodynamics, it is necessary to pick up fresh blood amin (dopamine). For example, gostra oliguria is indicated, dyuresis does not change 0.5 ml / kg / year. The temperature is within the reach of febrile values - 38-39 ° C; In order to be repaired by the court, in the case of hyperthermal conditions, the establishment of physical methods of cooling is introduced.

90% of the students in the secondary school suffer from a mental lack of a high degree of severity. Patients with decompensation and thermal breakdown of ailments will require a separate respiratory system. The stove and the spleen have been improved, their function has been ruined. There may be intestinal atony, flatulence, style with slime houses, blood and pus. At the lower stages, symptoms of desemination of the internal vascular larynx are detected: petechial visip, internal and external bleeding.

accelerating

Septic shock can lead to a number of important things. We will broaden them because of a polyorganic deficiency, when the function of two or more systems breaks down. In the first place, the heart of the central nervous system, legends, nirki and heart. Desceauts to develop the liver, intestines and spleen. The lethality of the middle of patients with PON reaches 60%. Some of them are guinea for 3-5 extra times for a critical camp. The price is surrounded by organic changes in the internal structures.

We will also expand the inheritance of ІTSh є bleeding as one. With the formation of intramuscular hematomas, the patient develops a clinic of a hospitable hemorrhagic insult. The purchase of extravazate in other organs can be produced until they are pressed. Reduction of blood pressure in the courtroom of the potential is more significant than a decrease in the arterial grip. Internal combustion engines on aphids of infectious-toxic shock become the cause of the patient's death in 40-45% of cases. Secondary damage to organs, provoking microthrombosis, which can be found on the cob stage of the formation of coagulopathy, is practically meaningful in 100% of patients.

diagnostics

Lіkuvannya septic shock

Patients are shown intensive therapy. Carry out treatment at the ICU department with the help of medical and medical treatment methods. Likuchiy lykar - resuscitator. The consultation of an infectious disease specialist, cardiologist, gastroenterologist, and others is also possible. It is necessary to transfer the sick person to the piece ventilation of the legends, to ensure the care of the middle medical staff, parenteral use. The sum and the products intended for introduction into the slurry do not become vicious. All methods are cleverly divided into pathogenetic and symptomatic:

Pathogenetic lykuvannya. When a person is susceptible to sepsis, the patient should be prescribed antibiotics. The scheme is guilty of including 2-3 drugs of different groups, which will contain a wide range of diy. Pidbir medication on the cob stage should be carried out with an empirical path, depending on the level of sensitivity of the child. One hour to check blood collection for sterility and dryness to antibiotics. The result of the analysis is prepared for 10 days. Until the end of the hour, I’ll give an effective likarska scheme without going into the distance;
Symptomatic treatment. Go to see the urahuvannya of the obvious classic picture. Consider ailments to receive massive infusion therapy, glucocorticoid, inotropic therapy, antiaggreganti, or hemostatics (in the presence of a laryngeal system). In case of a severe interruption of ailments, vikoristovuyut blood preparations: fresh frozen plasmas, albumin, immunoglobulins. Yakscho patients are in evidence, the introduction of analgesic and sedative reactions is shown.

Forecast and prevention

Septic shock is an unpleasant prognosis for life. With a subcompensated overload of guinea, close to 40% of ailments. Decompensated і termіnаlly, and end up bending 60% of patients. With the availability of free medical assistance, the mortality rate reaches 95-100%. A part of the ailing died through a few days of the death of a pathological camp. Prophylaxis of ITS polygons in the timely relief of diseases of the disease, competent treatment of antibiotic therapy in surgical ailments, in the treatment of antiseptic diseases in those with status, in order to take care of antibiotics