Qu’est-ce que le choc septique ?
Le choc septique !!! Que de personnes en meurent, surtout des vieux, parce qu’un vieux, c’est vulnérable comme un duvet au gré du vent. Et bien que cette situation grave soit devenue très courante, rares sont ceux qui possèdent les informations exactes pour éviter les complications. Ces complications peuvent être dangereuses et, dans 95 % des cas, aboutissent à une mort certaine.
Le choc septique : le sepsis à son origine.
Avant tout, expliquons ce qu’est un sepsis, à l’origine du choc septique. C’est tout simplement une infection généralisée du sang. Le choc septique apparaît quand le sepsis provoque une baisse dangereuse de la pression artérielle. Cela entraîne une diminution de l’oxygène envoyé aux organes. Le sang ne circule plus correctement. Les organes cessent alors de fonctionner comme il faut.
Le sepsis peut se développer à partir d’une infection abdominale (péritonite), d’une infection rénale (pyélonéphrite), ou encore d’une infection pulmonaire (pneumopathie). Les micro-organismes peuvent alors coloniser la zone infectée.
Le choc septique : personnes à risque.
Cette affection grave touche surtout les personnes fragiles ou immunodéprimées. Il s’agit notamment des nouveau-nés, des femmes enceintes, ou des personnes atteintes de maladies chroniques comme le diabète ou la cirrhose. Mais les personnes âgées sont les plus exposées. Le choc septique nécessite une prise en charge immédiate en unité de réanimation. C’est une urgence médicale absolue.
Les premiers signes d’alerte.
Les signes précoces d’un sepsis sont : une forte fièvre, un rythme cardiaque élevé (tachycardie), une transpiration abondante, une vasodilatation intense, une coagulation excessive, une respiration anormalement rapide
Défaillance des organes.
Au départ, le cœur essaie de compenser avec un débit cardiaque plus fort. Mais peu à peu, la perfusion des organes diminue. L’apport en oxygène devient insuffisant. Cela mène à une défaillance multi-viscérale.
Causes infectieuses.
Le choc septique est déclenché par une infection bactérienne, virale ou fongique. Ces agents pathogènes, une fois dans le corps, déclenchent une réponse immunitaire excessive. Les organes les plus affectés sont : le cœur, les reins, le foie, les poumons.
Évolution des symptômes.
Dans un premier temps, le patient ressent une grande fatigue et a de la fièvre. Son rythme cardiaque et respiratoire augmente. Le volume des urines diminue fortement. Les extrémités peuvent rester chaudes au début. Mais si le cœur ne compense plus, d’autres signes apparaissent : confusion mentale (agitation, somnolence, voire coma), altération du foie par manque d’irrigation, insuffisance rénale aiguë, saignements digestifs et ulcères, extrémités froides et bleuâtres, marbrures sur la peau.
Traitement.
Le traitement repose sur une antibiothérapie dite « probabiliste ». Elle consiste à administrer des antibiotiques à large spectre. Un remplissage vasculaire est aussi essentiel pour maintenir la tension artérielle au-dessus de 6,5 mm Hg. Des médicaments vasopresseurs comme la noradrénaline peuvent être nécessaires. Si cela ne suffit pas, l’hydrocortisone peut aider à diminuer l’inflammation. En cas de difficulté respiratoire, une oxygénothérapie est mise en place. Il faut également traiter la voie d’entrée de l’infection.
Conséquences en cas d’absence de traitement.
Sans traitement, le choc septique entraîne une défaillance des organes : le cœur, les reins, le cerveau. Dans les cas les plus graves, cela mène au décès.
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