Respiratory  failure
(arterial PO₂ <10kPa in air or PCO₂ >6)
Common in shock.  Capillary leak into lung parenchyma acute pulmonary oedema.  Clinically: tachypnoea, chest wall retraction, hypoxia.

Neurological dysfunction
In septicaemia, patients may be alert until late in the illness. Falling conscious level results from impaired cerebral blood flow and disturbed brain metabolism due to hypotension, hypoxia and acidosis.

Metabolic derangement
Septicaemia causes profound acidosis and derangements in metabolism, which may affect myocardial function and need correcting. Hypoglycaemia is common.  Hypokalaemia, hypocalcaemia, hypomagnesaemia and hypophosphataemia all occur.

Myocardial failure
Depressed myocardial function is multifactorial, including endotoxin, cytokines, multiple metabolic derangements, hypoxia, and hypovolaemia.  Clinically: tachycardia, gallop rhythm, cool peripheries and eventually hypotension.

Coagulopathy
(purpuric rash) Coagulopathy occurs early in patients with septicaemia. The laboratory findings of disseminated intravascular coagulation (DIC) are common in such patients. Coagulopathy is generally associated with the presence of a purpuric rash, but significant coagulopathy may infrequently occur in the absence of purpura.

Renal failure
Little or no urine output (<1ml/kg/hour) is a very early sign in septic shock, initially due to hypovolaemia. If shock persists then renal failure may occur. Serum creatinine 2 times upper limit of normal for age or 2-fold increase in baseline creatinine indicates renal dysfunction.