Septic Shock in a Baby
Septic Shock Lawyers & Cerebral Palsy Attorneys Helping Children who have Birth Injuries
Septic shock occurs when a baby develops sepsis (a bloodstream infection), and the sepsis progresses first to severe sepsis and then to septic shock. Sepsis in a newborn is typically caused by an infection in the mother that travels to the baby at birth. When a baby has septic shock, there is multiple organ dysfunction as well as dysfunction with the heart and blood flow. The baby’s blood pressure usually becomes very low and there is an abnormal amount of oxygen being delivered to the tissues, including brain tissue. Indeed, septic shock causes numerous medical emergencies, including major problems with how blood flows throughout the baby’s body, which can cause vital organs, such as the brain, to be deprived of adequate oxygen. If sepsis is quickly and properly treated, septic shock will not occur.
If shock is not promptly recognized and treated, it can cause major problems, such as a large decrease in circulating blood, which can cause the baby to have permanent brain damage, cerebral palsy, hypoxic ischemic encephalopathy (HIE) and seizures.
Progression of Septic Shock in Babies
Newborns develop early-onset sepsis by contracting an infection from the mother that is either transmitted to the baby through amniotic fluid or from bacteria that is infecting the mother’s genital tract, which the baby comes in contact with during delivery. Group B streptococcus (GBS), Escherichia coli and other bacteria can be transmitted to the baby before or during delivery and cause sepsis. Once bacteria gain access to the bloodstream, there may be overwhelming infection throughout the baby’s body (septicemia) and / or the infection can become localized in the baby’s lungs (pneumonia) or in the brain (meningitis).
This infection in the baby’s body can be so severe that it causes inflammation throughout the body, problems with the immune system, circulatory system dysfunction, and major organ problems. When a baby has septic shock, there are severe heart and vascular problems such as very low blood pressure, blood flow problems, decreased urine output and acidic blood (metabolic acidosis). The baby has inadequate blood getting to her tissues, and this can cause organ damage, including permanent brain injury.
A diagnosis of septic shock is made when the baby has signs of inadequate blood flow to the tissues (tissue perfusion), suspected or proven infection, and two signs of systemic inflammatory response syndrome (SIRS), which is an inflammatory state affecting the whole body. Signs of SIRS include a fast heart rate, high or low body temperature, fast breathing, and markers for infection, such as an abnormal number of white blood cells or immature neutrophils.
What to Expect if Your Baby Has Septic Shock
The serious medical problems that occur when a baby is in shock can perpetuate each other and create additional problems. Listed below are some of the things your baby may experience if she has septic shock.
- Use of a breathing machine called a ventilator. This is especially likely if the baby has pneumonia and / or respiratory distress.
- Hypothermia (baby’s core body temperature is lower than normal)
- Very fast or very slow heart rate
- Cool extremities
- Very fast breathing, very slow breathing, or periods whereby breathing stops for 20 seconds or more (apnea)
- Low blood pressure
- Altered mental state (baby is irritable, anxious, lethargic, overly sleepy or apneic)
- Sunken eyes
- Decreased urine output
Septic shock is the most common cause of neonatal death. Babies that survive may have permanent brain damage and cerebral palsy. However, if the shock is recognized early and prompt treatment is given, the child can have a good outcome. Of course, prompt treatment of sepsis is key so that septic shock never develops. But when a baby is in septic shock, supportive care and antibiotic treatment are equally important. Antibiotic treatment is of such critical importance that physicians should begin administering these drugs even if sepsis is suspected; they should not delay treatment while waiting for test results.
Septic Shock Treatment
Supportive treatment involves giving fluid therapy and using volume expansion drugs to increase the baby’s blood volume and blood pressure. Drugs that affect the baby’s blood vessels are often used in order to increase blood flow to vital organs. Oxygen therapy at 100% is initially used to increase oxygen delivery to the tissues, but this must be tapered down as soon as possible to avoid oxygen toxicity. The main goals of the numerous treatments given to babies who have septic shock are 1.) restoration of blood flow in the tissues (tissue perfusion), 2.) improvement of oxygen delivery to tissues / oxygenation, and 3.) normalization of cellular metabolism (energy demand and consumption).
Babies with septic shock are at risk for hypoglycemia (low blood sugar) and hypocalcemia (low blood calcium). Both conditions must be promptly treated. If left untreated, both conditions can cause heart and brain problems.
It is critical that improvement in circulation, perfusion (blood flow and delivery of blood to tissues) and organ function occur within the first 6 hours of a baby going into septic shock, and this is the main goal of treatment.
How Long Will It Take My Baby to Recover From Septic Shock?
When septic shock is recognized and the baby is resuscitated, meaning that her blood pressure, heart rate and other cardiovascular issues are stabilized, she may need to be transferred to a hospital that has neonatal critical care specialists. Babies in septic shock need to be treated by specialized teams, and it also is important that the team transporting the baby have expertise in managing neonatal septic shock.
The length of time of recovery from septic shock varies widely, and is dependent upon many factors, including the adequacy of organ function, blood pressure and perfusion. Lasting heart problems can slow down recovery, as can lung problems. Since many babies with sepsis require help with breathing, it may be weeks before respiratory distress and pneumonia resolve enough to allow the baby to breathe on her own. Some babies remain in the hospital for many weeks following septic shock. If the baby has brain damage and conditions such as hypoxic ischemic encephalopathy (HIE), meningitis or cerebral palsy, she may need frequent and regular visits to neurologists, therapists and other specialists.
How Does Septic Shock and Meningitis Cause Cerebral Palsy?
When a baby has sepsis or septic shock and the infection directly enters the central nervous system or causes inflammation in the brain, the baby may develop meningitis, which is inflammation of the membranes that surround the brain and spinal cord. Meningitis can cause fluid build-up in the brain, increased pressure in the brain, brain abscesses (pus-filled pockets), hydrocephalus, cerebral infarction (lack of blood flow to an area or areas of the brain) and stroke. These conditions are extremely damaging. Doctors should promptly treat sepsis and septic shock in order to decrease the risk of meningitis. It cannot be emphasized enough that the key to preventing meningitis and septic shock is prompt recognition and treatment of sepsis.
Signs of meningitis include a failure to respond to antibiotic therapy, bradycardia, respiratory depression, bulging fontanelle (soft spot), fast head growth, separation of parts of the skull (separation of cranial sutures), weakness on one side of the body, and seizures. When meningitis occurs, it must be treated as soon as possible to try and minimize the brain damage that can occur. Brain damage caused by meningitis can cause cerebral palsy, developmental delays, seizure disorders and learning disabilities.
Septic shock can cause hypoxic ischemic encephalopathy (HIE), seizures and cerebral palsy in numerous ways. The cardiovascular effects of shock can cause significant oxygen deprivation in the baby’s brain, which can cause permanent brain damage. Shock can also cause heart, liver and kidney dysfunction, which can also lead to brain damage. If the baby has significant breathing problems, such as pneumonia and / or respiratory distress, she is at risk of suffering from a lack of oxygen to her brain as well as overventilation injuries, which can cause cerebral palsy. Other issues caused by septic shock, such as metabolic problems, hypoglycemia, hypocalcemia and other electrolyte problems can either directly or indirectly affect the brain.
Michigan Cerebral Palsy Lawyers Helping Children with Septic Shock and Meningitis
Sepsis, septic shock, meningitis, HIE, seizure disorders and cerebral palsy are very sad conditions to see in a baby. The award winning lawyers at Reiter & Walsh ABC Law Centers focus exclusively on birth injury cases. Helping children is our sole focus. Attorney Jesse Reiter, owner and president of ABC Law Centers, is the only attorney in Michigan who has spent his entire 28+ year career focusing on birth injury cases. Jesse helps children in Michigan and throughout the nation, and once he takes a case, he spends a great deal of time getting to know the child and family he is helping so he can fully understand the child’s needs.
Jesse has won many awards for his advocacy of children, and he is currently recognized as being one of the best medical malpractice attorneys in America by U.S. News and World Report 2014, as well as one of the 10 Best Attorneys in Michigan by Super Lawyers magazine. Reiter & Walsh ABC Law Centers is currently recognized as being one of the best medical malpractice firms in the nation by U.S. News and World Report 2014.
Cerebral palsy, meningitis and septic shock are difficult areas of law to pursue due to the complex nature of the disorders and the medical records that support them. The birth injury lawyers at Reiter & Walsh have decades of experience with birth injury cases. To find out if you have a case, contact our nationally recognized firm to speak with an experienced attorney. We handle cases in Michigan, Ohio, Washington, D.C. and throughout the nation. We have numerous multi-million dollar verdicts and settlements that attest to our success and no fees are ever paid to our firm until we win your case. Email or call us at 888-419-2229. Our firm’s attorneys are available 24/7 to take your call. We give personal attention to each child and family we represent.