Septic shock: a clinical perspective

Septic shock may occur in otherwise normal individuals but is frequently a fatal sequel to infection in the elderly, the diabetic, or the debilitated patient. Mortality rates range from 40 to 95 per cent depending both on host factors and on the speed of initiation of appropriate therapy. The complexities of shock pathophysiology and biochemistry are elusive, but certain hemodynamic derangements are clearly described and create obvious therapeutic imperatives. Correction of the supply-dependent phase of oxygen consumption is the cornerstone of supportive therapy. Survival is primarily dependent on the rapid delivery of the appropriate antibiotics, surgical drainage and debridement of any infected tissues or abscesses, and aggressive volume resuscitation at the very time early sepsis is diagnosed. Septic shock is a medical emergency.