Why Sepsis Causes Hypotension?

April 6, 2024 | by Yashaswi Pathakamuri | Posted in FAQ's

Sepsis

Sepsis is a severe and potentially life-threatening condition that occurs when the body’s response to an infection becomes dysregulated, leading to widespread inflammation and organ dysfunction. Hypotension, or low blood pressure, is a common complication of sepsis and is often a hallmark feature of the condition. Several factors contribute to hypotension in sepsis:

  • Vasodilation: Sepsis triggers a systemic inflammatory response, which can cause blood vessels throughout the body to dilate (widen). This vasodilation reduces vascular resistance, meaning that blood encounters less resistance as it flows through the vessels. As a result, blood pressure drops, leading to hypotension.
  • Increased Vascular Permeability: In addition to vasodilation, sepsis can also increase the permeability of blood vessel walls. This increased permeability allows fluid and proteins to leak out of the bloodstream and into the surrounding tissues. As a result, blood volume decreases, which further contributes to hypotension.
  • Fluid Loss: Sepsis can lead to fluid loss through various mechanisms, including increased permeability of blood vessel walls, gastrointestinal losses due to vomiting or diarrhea, and inadequate fluid intake due to altered mental status or decreased consciousness. Fluid loss reduces blood volume, which can cause hypotension.
  • Myocardial Depression: Sepsis can impair the function of the heart, a condition known as septic cardiomyopathy or myocardial depression. In septic cardiomyopathy, the heart’s ability to pump blood effectively is compromised, which can contribute to hypotension.
  • Dysregulated Immune Response: The dysregulated immune response in sepsis can lead to the release of various inflammatory mediators, such as cytokines and nitric oxide, which can directly affect blood vessel tone and contribute to hypotension.
  • Mitochondrial Dysfunction: Sepsis can impair cellular metabolism and energy production, including dysfunction of mitochondria (the cell’s energy-producing organelles). This mitochondrial dysfunction can lead to cellular and organ dysfunction, including impaired cardiovascular function, which can manifest as hypotension.

Overall, hypotension in sepsis is the result of complex interactions between inflammation, vasodilation, fluid loss, myocardial depression, and dysregulated immune responses. Prompt recognition and aggressive management of hypotension are essential in the management of sepsis to prevent further organ dysfunction and improve outcomes for patients.

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