The septic syndrome. An oncologic treatment challenge.

The septic syndrome has three phases, characterized by alterations in tissue perfusion (phase I), fluid volume (phase II), and cardiac output (phase III). It must be viewed as a continuum: the degree of illness and the rate of mortality increase with each stage. Each phase must be clearly understood by health-care professionals for them to be able to intervene actively to prevent a patient's progressive deterioration. Since the septic syndrome frequently cannot be treated effectively in the advanced stage, the nurse's role must focus on early detection of infection, thorough evaluation of all the parameters, and expeditious initiation of treatment in collaboration with the physician. The high mortality of cancer patients who develop septic shock is an incentive for nurse and physician to work together to prevent this serious condition and provide maximum support if it should occur. The nurse's ability to make critical judgments derived from a knowledgeable assessment of clinical data can positively influence the outcome. The timeliness of the nursing intervention may determine the patient's fate.