Comparison Between Early and Late Shock and Early and Late Sepsis

Sepsis is a life-threatening body condition that arises from the body's response system to an infection. In response to an infection, the body usually releases the relevant chemicals into the bloodstream to fight the infection. Sepsis takes place when these produced chemicals are out of balance. This imbalance causes changes in the body that end up damaging several body organs. When sepsis is left unattended to, it advances into septic shock where the body blood pressure drops significantly. Shock is a condition where the blood circulatory system is dysfunctional as a result of unmet metabolic demands (Neville, Damm & White, 2003). Since sepsis is caused by an infection, it can happen to anyone. Sepsis condition is dangerous and can threaten one's life especially to special groups of people such as pregnant women, older adults, younger children in the age bracket less than one year, people with weak immune systems and people with chronic conditions. This infection is divided into two categories, including the early-onset sepsis (EOS) and late-onset sepsis (LOS).

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Etiology

Sepsis is caused by the body's response to an infection, by producing relevant chemicals in its defense and instead, the imbalance of the released chemicals results to self-harm when the chemical harms the body's tissues and organs. This may result in death or significant morbidity. Shock can be categorized into psychologic or physiologic. Psychologic type of shock is caused by a distressful event that may affect the normal functioning of the brain (Neville, Damm & White, 2003). This type of shock results in both emotional and physical responses from the body. the body gets into a state of shock as a result of an insufficient amount of blood circulating the body system to keep the body organs functioning properly. This lack of enough blood in the body can be caused by physical injury or an infection that disrupts the normal flow of blood. Shocks have various impacts on the body and can result in the failure of multiple organs in the body, which may lead to life-threatening complications. On the other hand, sepsis infection is divided into two categories, including the early-onset sepsis (EOS) and late-onset sepsis (LOS). EOS is the sepsis that occurs within the first 72 hours of life or during the first week of the life of an infant, whereas, LOS refers to the sepsis that presents itself after the first seven days of life. Sepsis is caused by various types of microbes such as bacteria, fungi, and viruses.

Pathophysiology

Shock is an acute reduction in the effective tissue perfusion which results in insufficient supply of oxygen to the body tissues and thereafter the imbalance of anaerobic metabolism. The pathophysiological events associated with different types of shocks include changes in the composition of body fluid compartments and various mediators. Shock results from the intravascular volume, systemic vascular resistance, intravascular volume and distribution of blood flow. Conversely, neonatal sepsis is an infection that specifically affects newborn babies (Seltmann & Holst, 2002). Sepsis results when an inflammatory reaction is triggered by an infectious insult in the body. the inflammatory reaction is normalized by the release of cytokines such as tumor necrosis factor-alpha, prostaglandins and interleukins from neutrophils and macrophages. Fibrinolysis is then inhibited as a result of activation of extrinsic coagulation cascade by the released cytokines. These overlapping processes give birth to microvascular thrombosis. This factor is the main cause of organs dysfunction in the body.

Respiratory Intervention

Severe sepsis or septic shock is as a result of a vigorous inflammatory response to infectious pathogens. This shock results to the acute respiratory distress syndrome (ARDS) that may have high mortality. ARDS is a critically dangerous complication of severe sepsis, that increases the rates of patients' fatality and risk of other factors of ARDS. Shock is defined as the acute failure of the circulatory system (Seltmann & Holst, 2002). This is associated with the inadequate distribution of tissue perfusion that results in generalized cellular hypoxia. The blood circulation in the body should meet the metabolism requirements for efficient function of body organs.

Shock can be detected by the impacts it leaves of the affected body organs. Looking at the perfusion of the organs can help to identify the extent of shock the body system went through. Lack of sufficient oxygen in the body causes body cells to revert to the anaerobic mechanism, which is inefficient in body energy production compared to aerobic metabolism. Anaerobic metabolism produces excessive amounts of pyruvate which is converted to lactate prolonged hypoperfusion that builds up hydrogen ions from the lactic acid resulting in metabolic acidosis (Mulberg, Silber & Van, 2009). Toxic metabolites are created by insufficient blood circulation in the body which cannot clear easily from the body. Different types of shock may come by such kind of toxic metabolites on the way leading to microcirculatory dysfunction and hypoxemia and energy uncoupling that may lead to death.

Management

Severe sepsis or septic shock is as a result of a vigorous inflammatory response to infectious pathogens. This shock results in the acute respiratory distress syndrome (ARDS) that may have high mortality. ARDS is a critically dangerous complication of severe sepsis, that increases the rates of patients' fatality and risk of other factors of ARDS. Shock is defined as the acute failure of the circulatory system (Seltmann & Holst, 2002). This is associated with the inadequate distribution of tissue perfusion that results in generalized cellular hypoxia. The blood circulation in the body should meet the metabolism requirements for efficient function of body organs. Shock can be detected by the impacts it leaves of the affected body organs. Looking at the perfusion of the organs can help to identify the extent of shock the body system went through. Lack of sufficient oxygen in the body causes body cells to revert to the anaerobic mechanism, which is inefficient in body energy production compared to aerobic metabolism. Anaerobic metabolism produces excessive amounts of pyruvate which is converted to lactate prolonged hypoperfusion that builds up hydrogen ions from the lactic acid resulting in metabolic acidosis (Mulberg, Silber & Van, 2009). Toxic metabolites are created by insufficient blood circulation in the body which cannot clear easily from the body. Different types of shock may come by such kind of toxic metabolites on the way leading to microcirculatory dysfunction and hypoxemia and energy uncoupling that may lead to death.

The antibiotic therapy of early sepsis affects both the gram-negative and gram-positive microorganisms. During the prescription of antibiotics, it is vital to recommend a wide range and avoid a group of antibiotic bacteria (Evans & Brachman 1998). In the case of the late sepsis, it is vital that the medication affects the staphylococcus and gram-negative bacteria. In this regard, penicillin is preferred to be prescribed. In the absence of clinical symptoms, it is recommended a duration of 7 or more days and recommendation of gram+flora (Evans & Brachman, 1998). In the case of a minimum gram+flora, a recommendation of 14 days is necessary. In the case of meningitis 21 days of therapy is recommended. The period of antibacterial therapy depends on the clinical form of infection. It is recommended that the physician should only change the method of therapy in the case of lack of effects from the conducted therapy.

Outcomes

One can survive shocks and recover fully from the condition. This is only possible when the condition is treated quickly and prevents the possible causes of permanent organ damage. Chances of recovery after sequences of shock conditions depend on many factors including the cause of shock, the length of time one is in shock, the extent of body area damage that one sustained, treatment received, age and medical history among others. Various types of shocks can be preventable they include following of medical prescriptions. If one is diagnosed with severe allergies, it is recommended one to avoid the allergy triggers hence preventing possible shocks (Mulberg, Silber & Van, 2009). One can lower the risk of blood loss by protecting their body against body injuries by wearing protective body gears. To lower the risk of damaging the heart and the respiratory system, one should eat a balanced diet and avoid direct smoking as well as second-hand smoking. Leading a balanced life is the key to having a healthy life. Balance of nutrients intake, exercises, and stress management is vital in the management of body diseases.

Conclusion

Neonatal sepsis and shocks affecting young infants are a risky health hazard to the lives of the children and should be analyzed and diagnosed immediately and treated. Delay in treatment of these conditions may affect the future developmental stages of the infants or lead to an early death. Sepsis has been a major challenge in the medical field for a long time and research on how to deal with it is ongoing as other reliable measures are put in place to minimize the impacts of the infection. These infections have continued to affect many lives due to the existence of microorganisms that are ever in existence. Early recognition of the infection leads to early interventions which help in saving lives. It has been one of the major causes of children's death and it is a worrying trend that needs medical intervention. Shock is as a result of various health conditions such as pneumonia, malaria, diarrhea and neonatal pneumonia or sepsis. In this regard, the management of sepsis and the relevant infections that lead to shocks is vital as it will prevent these diseases and end up saving lives.

References

Evans, A. S., & Brachman, P. S. (1998). Bacterial Infections of Humans: Epidemiology and Control. Boston, MA: Springer US.

Mulberg, A. E., Silber, S. A., & Van, A. J. N. (2009). Pediatric drug development: Concepts and applications. Hoboken, N.J: John Wiley.

Neville, B. W., Damm, D. D., & White, D. K. (2003). Color atlas of clinical oral pathology. Hamilton, Ont: BC Decker.

Seltmann, G., & Holst, O. (2002). The Bacterial Cell Wall. Berlin, Heidelberg: Springer Berlin Heidelberg.

Strand, C. L., & Shulman, J. A. (1988). Bloodstream infections: Laboratory detection and clinical considerations. Chicago: ASCP Press.