Sepsis

Sepsis is an acute life-threatening organ failure caused by an exaggerated or extremely weak immune response of the body to an infection. This means: Sepsis is always triggered by an infection. The body's own defence system is ramped up, but still cannot prevent the infection from spreading in the whole body.

As a result, organs and tissues are not supplied with sufficient nutrients and ultimately organs fail. For example, the lungs can fail. In this case, the patient needs respiratory support measures such as additional oxygen or mechanical ventilation.

If the blood pressure is still too low (hypotension) despite so-called volume therapy (administration of sufficient fluid as an infusion) and the administration of circulation-supporting drugs (vasopressors) becomes necessary, this is called septic shock.

Any patient with an infection can get sepsis. However, there are factors that can influence the occurrence and severity of the course.

Risk groups include:
Patients with weakened immune systems, e.g.

• New-borns and young children (mainly affects the first year of life)
• Elderly people (with increasing frequency in those over 60 years of age)
• people who do not have a (functioning) spleen
• People who need to take certain medicines (e.g. to treat rheumatism)
• People who have had an organ transplant
• People with AIDS

People with chronic diseases, e.g.

• Diabetes mellitus
• Cancer
• Kidney or liver disease
• Respiratory diseases, especially those treated with cortisone or the like
• Dependency diseases (alcohol, drugs)

People with ports of entry for pathogens, e.g.

• Open wounds after an operation
• Severe internal or external injuries
• Extensive burns
• People with a catheter or drain in place

The symptoms of sepsis are often non-specific. Fever, chills, palpitations, low blood pressure, confusion and breathing problems are among them. In addition, sepsis can manifest itself very differently in individual sufferers. The symptoms usually do not occur singularly, but in a combination.

In order to detect a life-threatening threat in high-risk patients at an early stage, the S3 guideline "Sepsis - Prevention, Diagnosis, Therapy and Follow-up" recommends using the Quick SOFA (qSOFA) in patients outside intensive care units who are suspected of having an infection.

This means that a doctor should be consulted if at least two of the following early signs are present and infection is suspected:

• New onset of changes in consciousness
• Rapid breathing (respiratory rate > 22/minute)
• Low (systolic) blood pressure ≤ 100 mm Hg

S3 guidelines reflect the tested and very well-evidenced state of the art of medicine in diagnosis, treatment and rehabilitation as well as prevention. Guidelines are not legally binding.