Blood poisoning (sepsis, septicemia)

Sepsis - signs, causes and treatment

Blood poisoning is not always immediately recognizable and is often underestimated. It is a defense reaction of the body to an infection that spreads to the entire body and can be life-threatening. Frequently, the condition of the patient worsens within a very short time, so that sepsis always requires rapid therapy and immediate intensive care treatment.

contents

• Sepsis - signs, causes and treatment
• Definition - What is a blood poisoning?
• symptoms
• disease
• causes
• Risk patients for blood poisoning
• diagnosis
• treatment
• Deadly despite treatment?
• Naturopathic treatment
• Current state of research

Definition - What is a blood poisoning?

Sepsis, also known as blood poisoning, is caused by a variety of processes and by the body's excessive response to an infection that causes life-threatening functional impairment of organs. The blood poisoning is therefore an evoked immune response to a local infection, with pathogens (mostly bacteria) from a source of inflammation thrust or steady into the bloodstream.

The sepsis is characterized by an excessive spread of pathogens in the organism, which leads to the systemic symptoms of Bultvergiftung. (Image: Kateryna_Kon / fotolia.com)

The first International Sepsis Definition of 1992 was based on the simultaneous presence of infection and at least two criteria for a systemic inflammatory response of the organism also called "Systemic Inflammatory Response Syndrome" (SIRS). Depending on the severity of the disease, a distinction was made between sepsis (whole body infection), severe sepsis (organ failure) and septic shock (drop in blood pressure, multiple organ failure). The insufficiently specific criteria and medical findings led to additional definitions of sepsis. The most recent and so-called sepsis-3 definition describes this as a life-threatening organ dysfunction due to a dysregulated body response to an infection. The extent of the present organ failure therefore plays an important role in the diagnosis and treatment, however, according to the valid definition, only a distinction is made between sepsis and septic shock. (see Deutsches Ärzteblatt)

symptoms

Sepsis is not always easy to recognize at first because the first signs are usually very unspecific:

• Fever (≥ 38 ° C) or less often also low temperature (≤ 36 ° C)
• Fast and shallow breathing (tachypnea), frequency ≥ 20 / min
• High heart rate and heart rate (tachycardia), frequency ≥ 90 / min
• Low blood pressure (hypotension)
• malaise
• Consciousness Consumption (Confusion)
• Decreased urine output

The main symptom of sepsis is high fever or relapses of fever, with a rapid rise in the fever and falling to normal levels within 24 hours. The fever is often accompanied by chills (adults) and febrile seizures (babies and toddlers). But this fever can also be completely absent, especially in infants, toddlers and immunocompromised people. In addition to the signs of one of these symptoms may be added to the infection that has caused the blood poisoning.

A red line on the skin (for example, on the arm), which is mentioned again and again as sepsis signs, actually only rarely plays a role. This arises from inflammation of lymphatic vessels (lymphangitis). However, sepsis may develop as a complication of such inflammation, the so-called "fake" blood poisoning.

When the mentioned, albeit non-specific, symptoms, you should keep the possibility of sepsis in mind and better early to see a doctor.

disease

In cases of blood poisoning, sufferers often feel seriously ill with a rapid deterioration of the general condition. The skin is cold, pale gray to bluish and it can cause skin bleeding and other skin symptoms. If the symptoms remain untreated, the blood pressure drops so much that vital organs such as the heart, lungs and brain are no longer sufficiently supplied with oxygen and corresponding organ functions are thus impaired or even fail. It causes drowsiness, changes in consciousness (confusion) and palpitations. Other potential complications of sepsis include coagulation disorders, multi-organ failure, and septic dislocations in the brain, where bacterial herd and pus accumulation can lead to embolic herpetic encephalitis (inflammation of the brain).

Numerous different pathogens are considered triggers of blood poisoning and the exact determination of the pathogens is important for choosing the right therapy. (Image: Yenes / fotolia.com)

causes

The trigger of blood poisoning is usually a local infection. Common sepsis are infections of hollow organs with difficult drainage, e.g. Renal pelvic inflammation in prostate enlargement or urinary retention, also wound infections, pneumonia but also chronic inflammation of the upper respiratory tract (sinusitis, otitis, tonsillitis). More than half of the blood poisonings originate from the genitourinary tract (urosepsis). Pathogens, which are mostly Gram-negative bacteria, enter the bloodstream and thus all body organs from the inflammatory foci. There it comes to infectious stray soils, the septic metastases. In addition to bacteria but also viruses, fungi or other germs can be causes of the infections, which can ultimately lead to sepsis.

Usually, the immune system fights the pathogens, so that heals an infection and no further consequences and complications are expected. Under certain circumstances, e.g. a general defensive weakness, this is the body but not possible. As a result, the pathogens can multiply uncontrollably and enter the bloodstream in large numbers from the inflammatory focus. In the following, excessive immune response, the immune system responds to the pathogens and their products (e.g., toxins), and via messenger substances, multiple responses and symptoms of sepsis are elicited. The causes of blood poisoning in addition to an infection also an excessive immune response attributable to the entire body.

Risk patients for blood poisoning

Particularly at risk are older and chronically ill people, newborns and infants as well as people with a weakened immune system. The reasons for an immunodeficiency are manifold, for example, an immunodeficiency can be inherited or triggered by illnesses and the associated use of medication. The removal of the spleen also leads to a weakened immune system.

In addition, patients also suffer from sepsis after an operation or intensive care unit patients, because existing germs can be easily transmitted here. But also otherwise completely healthy people can fall ill, because often is only a small injury and their infection, z. As a tooth or bladder infection, exit for the serious complication.

The early diagnosis of sepsis is crucial for the success of treatment, however, the symptoms are sometimes relatively unspecific and the symptoms are not directly related to blood poisoning. (Image: DOC RABE Media / fotolia.com)

diagnosis

Decisive for a successful treatment and the chances of survival in a sepsis is an early detection of the disease. But because the symptoms are not clear, a quick diagnosis is a challenge. It is important that in case of the mentioned symptoms immediate medical help is consulted. In sepsis, every second counts. If, after the examination, the doctor considered it possible or even diagnosed with sepsis, the patient is usually immediately classified as a medical emergency and admitted to hospital for intensive care.

Sepsis or septic shock?

The determination of the infection and the determination of the cause or the recognition of the inflammatory focus and thus the sepsis are a prerequisite for the further treatment of those affected. By determining the pathogens, appropriate forms of therapy, such as antibiotics, can be selected and adjusted, thus maximizing the chances of treatment success. But not always the cause of infection can be found.

It is now possible to detect sepsis more quickly through special blood tests, but individual disease processes and associated potential complications play a major role in the severity of diagnosed sepsis. The blood values ​​can provide information on possible pathogens, inflammation and defense reactions of the patient, as well as provide information on organ dysfunction. The latter indicates a severe course of sepsis and the possibility of a septic shock, in which 30 to 50 percent of patients die even under the best treatment conditions.

In addition to blood pressure and blood testing, further examinations (such as ultrasound, X-ray, or computed tomography) can be performed to check important organ functions, such as heart, lung, kidney, or liver function. A blood clotting test can also be part of the diagnosis.

treatment

Sepsis is life-threatening and requires intensive care treatment as soon as possible. Most bacteria are the cause of the infection that has triggered sepsis. If these could be determined during the diagnosis, the therapy consists of a high dose of antibiotics. At the start of treatment and lack of identification of the pathogens so-called broad spectrum antibiotics or other agents are used, which act against a variety of bacteria and germs. Are not bacteria the cause other forms of therapy can lead to successful treatment, such as so-called antifungals against fungal diseases. In addition, infusions to compensate for fluid loss and to stabilize the circulation are given and, if necessary, the sepsis is surgically removed. If there is already a septic shock, vital measures for the restoration of organ functions and organ care up to organ replacement measures are carried out before the infection treatment.

Antibiotics are the common treatment for bacterial sepsis. Also come sometimes even before the exact determination of the pathogens so-called broadband antibiotics Eisnatz to intervene in an emergency as early as possible. (Image: Zerbor / fotolia.com)

Deadly despite treatment?

In sepsis, there is no one hundred percent cure and chance of survival. Blood poisoning is the third most common cause of death after cardiovascular disease and cancer. The high mortality rate in sepsis is often attributed to the fact that more and more old, seriously ill and injured people initially survive their underlying disease through modern intensive care, but succumb to sepsis in the hospital - often due to a deficiency. This, as Nosokomialsepsis (Greek nosokomeion = hospital) designated septicemia represents the largest proportion of septic disease forms.

Naturopathic treatment

Sepsis is a serious and life-threatening disease in which rapid and targeted antibiotic therapy and, where appropriate, intensive care are crucial for treatment and survival. Sepsis is always a case for intensive care and emergency medicine.
So far, little is known about possible improved therapeutic success through an additional use of naturopathic medicines. Strengthening the immune system based on natural healing can not prevent sepsis, but it is always good advice.

Current state of research

Scientific findings have already led to a fundamentally changed definition of sepsis and to a change in the understanding of the serious illness. However, it is still important to answer essential open questions through research in order to increase the success rate for diagnosis and therapy and thus to lower the mortality rate. Sepsis research is being driven forward at the Integrated Research and Treatment Center (IFB) Sepsis and Sepsis Sequences (CSCC) in Jena. (Dipl.Päd. Jeanette Viñals Stein, non-medical practitioner, Dr. rer. Nat. Corinna Schultheis, updated on 14.06.2018)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)