How do tachycardia and tachypnea manifest in sepsis/septic shock?

Updated: Oct 07, 2020
  • Author: Andre Kalil, MD, MPH; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
  • Print

Tachycardia is a common feature of sepsis and indicative of a systemic response to stress; it is the physiologic mechanism by which cardiac output, and thus oxygen delivery to tissues, is increased. Tachycardia indicates hypovolemia and the need for intravascular fluid repletion; however, an increased heart rate often persists in sepsis despite adequate fluid repletion. Narrow pulse pressure and tachycardia are considered the earliest signs of shock. Tachycardia may also be a result of fever itself.

Tachypnea is a common and often underappreciated feature of sepsis. It is an indicator of pulmonary dysfunction and is commonly found in pneumonia and acute respiratory distress syndrome (ARDS), both of which are associated with increased mortality in sepsis. Stimulation of the medullary ventilatory center by endotoxins and other inflammatory mediators is a possible cause. As tissue hypoperfusion ensues, the respiratory rate also rises to compensate for metabolic acidosis. The patient often feels short of breath or appears mildly anxious.

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!