Skip to main content
SpringerLink
Log in

Chocs d’allure septique

Sepsis-like shocks

  • Enseignement Supérieur en Réanimation
  • Published:
Réanimation

Résumé

Très utilisée pour la classification des patients lors de la réalisation d’études cliniques, la définition usuelle du choc septique est cependant régulièrement critiquée pour son manque de spécificité. Un grand nombre d’affections est en effet susceptible de déclencher, à un stade variable de leur évolution des manifestations cliniques ou biologiques très similaires à celles observées au cours d’un choc infectieux. Ces « chocs pseudo-septiques » peuvent être en rapport avec une inflammation systémique aiguë, un phénomène d’ischémie-reperfusion globale, une réaction d’origine toxique ou anaphylactique, un trouble de la régulation centrale de la température, ou encore des perturbations métaboliques ou endocriniennes. Il est capital de savoir les évoquer au moindre doute, car leur prise en charge est souvent radicalement différente, exigeant la mise en oeuvre immédiate de thérapeutiques spécifiques.

Abstract

Widely used for classification of patients in clinical studies, the usual definition of septic shock is however regularly criticized for its lack of specificity. Many diseases are likely to produce clinical or biological manifestations similar to those observed in septic shock. These “septiclike shocks” may be related to different causes like acute systemic inflammation, global ischemia-reperfusion, toxic reaction, anaphylactic troubles, disorders in central regulation of temperature as well as metabolic or endocrine disturbances. It is of crucial importance to suspect these etiologies, since treatment is often totally different, requiring the immediate implementation of specific therapies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Références

  1. Lanceleur A, Cariou A, Dhainaut JF (2009) États de choc: physiopathologie et mécanismes généraux. Traité de Réanimation Médicale. Ed Masson 774–777

  2. Members of American College of chest Physicians/Society of Critical Care Medicine Consensus Conference Commitee (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20:864–874

    Article  Google Scholar 

  3. Klein Klouwenberg PM, Ong DS, Bonten MJ, et al (2012) Classification of sepsis, severe sepsis and septic shock: the impact of minor variations in data capture and definition of SIRS criteria. Intensive Care Med 38:811–819

    Article  PubMed  Google Scholar 

  4. Lorne E, Dupont H, Abraham E (2010) Toll-like receptors 2 and 4: initiators of non-septic inflammation in critical care medicine? Intensive Care Med 36:1826–1835

    Article  PubMed  CAS  Google Scholar 

  5. Hochman JS (2003) Cardiogenic shock complicating acute myocardial infarction: expanding the paradigm. Circulation 107:2998–3002

    Article  PubMed  Google Scholar 

  6. Dzavík V, Cotter G, Reynolds HR, et al (2007) Effect of nitric oxide synthase inhibition on haemodynamics and outcome of patients with persistent cardiogenic shock complicating acute myocardial infarction: a phase II dose-ranging study. Eur Heart J 28:1109–1116

    Article  PubMed  Google Scholar 

  7. Abraham E (1999) Why immunomodulatory therapies have not worked in sepsis. Intensive Care Med 25:556–566

    Article  PubMed  CAS  Google Scholar 

  8. Solomon LA, Hinshaw LB (1968) Effect of endotoxin on isogravimetric capillary pressure in the forelimb. Am J Physiol 214:443–447

    PubMed  CAS  Google Scholar 

  9. Schutzer KM, Larsson A, Risberg B, Falk A (1993) Lung protein leakage in feline septic shock. Amer Rev Resp Dis 147:1380–1385

    PubMed  CAS  Google Scholar 

  10. Monafo WW (1996) Initial management of burns. N Engl J Med 335:1581–1586

    Article  PubMed  CAS  Google Scholar 

  11. Gueugniaud PY, Vilasco B, Pham E, et al (1996) [Severe burnt patients: hemodynamic state, oxygen transport and consumption, plasma cytokines]. Ann Fr Anesth Reanim 15:27–35

    Article  PubMed  CAS  Google Scholar 

  12. Polk HC (1979) Supportive therapy in burn care. Consensus summary on infection. J Trauma 19(11 Suppl):894–896

    CAS  Google Scholar 

  13. Levitt MD, Eckfeldt JH (1993) Diagnosis of acute pancreatitis. In: The pancreas. Biology, pathobiology and disease (pp. 613–635) Go VLW, DiMagno EP, Gardner JD, Lebenthal E, Reber HA, Scheele GA, (eds). New York, Raven Press

    Google Scholar 

  14. Lankisch PG, Schirren CA, Kunze E (1991) Undetected fatal acute pancreatitis: why is the disease so frequently overlooked? Am J Gastroenterol 86:322–326

    PubMed  CAS  Google Scholar 

  15. Godeau B, Mortier E, Roy PM, et al (1997) Short and long-term outcomes about patients with systemic rheumatic diseases in intensive care units: a prognostic study of 181 patients. J Rheumatol 24:1317–1323

    PubMed  CAS  Google Scholar 

  16. Hellmann DB, Petri M, Whiting-O’Keefe Q (1987) Fatal infections in systemic lupus erythematosus: the role of opportunistic organisms. Medicine (Baltimore) 66:341–348

    CAS  Google Scholar 

  17. Eberhard OK, Haubitz M, Brunkhorst FM, et al (1997) Usefulness of procalcitonin for differentiation between activity of systemic autoimmune disease (systemic lupus erythematosus/systemic antineutrophil cytoplasmic antibody-associated vasculitis) and invasive bacterial infection. Arthritis Rheum 40:1250–1256

    PubMed  CAS  Google Scholar 

  18. Delevaux I, Andre M, Colombier M, et al (2003) Can procalcitonin measurement help in differentiating between bacterial infection and other kinds of inflammatory processes? Ann Rheum Dis 62:337–340

    Article  PubMed  CAS  Google Scholar 

  19. Levin MA, Lin HM, Castillo JG, et al (2009) Early oncardiopulmonary bypass hypotension and other factors associated with vasoplegic syndrome. Circulation 120:1664–1671

    Article  PubMed  Google Scholar 

  20. Safar P, Behringer W, Bottiger BW, et al (2002) Cerebral resuscitation potentials for cardiac arrest. Crit Care Med 30:S140–S144

    Article  PubMed  Google Scholar 

  21. Adrie C, Adib-Conquy M, Laurent I, et al (2002) Successful cardiopulmonary resuscitation after cardiac arrest as a “sepsis-like” syndrome. Circulation 106:562–568

    Article  PubMed  Google Scholar 

  22. Stewart I, Lewis RJ, Eaglesham GK, et al (2010) Emerging tropical diseases in Australia. Part 2. Ciguatera fish poisoning. Ann Trop Med Parasitol 104:557–571

    Article  PubMed  CAS  Google Scholar 

  23. Bourcier S, Mongardon N, Daviaud F, et al (2012) Disulfiram ethanol reaction mimicking anaphylactic, cardiogenic, and septic shock. Am J Emerg Med [E-pub ahead of print]

  24. Dewachter P, Jouan-Huraux V, Franck P, et al (2005) Anaphylactic shock: a form of distributive shock without inhibition of oxygen consumption. Anesthesiology 103:40–49

    Article  PubMed  Google Scholar 

  25. Fourel D, Ould Ahmed M, Ralec B, et al (2009) Traité de Réanimation Médicale. Ed. Masson pp: 1643–1646

  26. Llach J, Gines P, Arroyo V, et al (1998) Prognostic value of arterial pressure, endogenous vasoactive systems, and renal function in cirrhotic patients admitted to the hospital for the treatment of ascites. Gastroenterology 94:482–487

    Google Scholar 

  27. Masset C, Lancellotti P, Nkoghe D (2001) Shoshin beriberi: myth or reality? Rev Med Liege. 56:155–158

    PubMed  CAS  Google Scholar 

  28. Dorin RI, Kearns PJ (1988) High output circulatory failure in acute adrenal insufficiency. Crit Care Med 16:296–297

    Article  PubMed  CAS  Google Scholar 

  29. Jiang YZ, Hutchinson KA, Bartelloni P, et al (2000) Thyroid storm presenting as multiple organ dysfunction syndrome. Chest 118:877–879

    Article  PubMed  CAS  Google Scholar 

  30. Cooper DS (2003) Hyperthyroidism. Lancet 362:459–468

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service de réanimation médicale, hôpital Cochin (AP-HP), 27 rue du Faubourg Saint-Jacques, F-75679, Paris cedex 14, France

    F. Daviaud, A. Bouglé & A. Cariou

  2. Université Paris Descartes, 12 rue de l’École de Médecine, 75006, Paris, France

    F. Daviaud, A. Bouglé & A. Cariou

Authors
  1. F. Daviaud
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Bouglé
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Cariou
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Cariou.

Additional information

Cet article correspond à la conférence faite par l’auteur au congrès de la SRLF 2013 dans la session: Des maladies qu’il faut connaître.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Daviaud, F., Bouglé, A. & Cariou, A. Chocs d’allure septique. Réanimation 22 (Suppl 2), 428–434 (2013). https://doi.org/10.1007/s13546-012-0542-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13546-012-0542-1

Mots clés

Keywords

Search

Navigation