How is septic shock treated?
Treatment of septic shock is difficult and complex. Early recognition and aggressive resuscitation are critical to improving outcomes. Fluid therapy is usually employed first, but pressor agents are often required. Treatment with antibodies directed against the inflammatory mediators has not proved to be effective, but as our understanding of this complex process evolves, effective immunomodulator therapy may be developed. Interestingly, although antibiotics are needed to limit the infectious process, they alone are not sufficient treatment for septic shock. In certain cases, they may actually increase the antigen load in the system by destroying gram-negative organisms, which results in more LPS in the circulatory system. However, patients who do not receive adequate antibiotic therapy have a higher mortality rate than those receiving such therapy. Additionally, antibiotics alone may be insufficient for source control, and sometimes surgical control is needed to eradicate the source.
Brierley J, Carcillo JA, Choong K, et al: Clinical practice parameters for hemodynamic support of pediatric and neonatal septic shock: 2007 update from the American College of Critical Care Medicine. Crit Care Med 2009;37(2):666-688.