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Septic shock: diagnosis
Last reviewed: 23.04.2024
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For the purpose of possibly early diagnosis of septic shock, it is rational to isolate patients with a high risk of developing this pathology for special surveillance . These are considered patients with acute manifestation of infection (rapid development of severe temperature reaction, the presence of repeated chills, pathological manifestations of the central nervous system and vomiting). These patients, along with the treatment of the underlying disease, should be carefully and regularly monitored for the following parameters:
- Control blood pressure measurement and pulse counting every 30 minutes.
- Measurement of body temperature every 3 hours.
- Determination of hourly urine output, for which a permanent catheter is inserted into the bladder.
- Taking a smear from the lesion and painting it according to Gram. The identification of gram-negative flora confirms the danger of septic shock development.
- Sowing material from the lesion, urine and blood for bacteriological research and determining the sensitivity of the flora to antibiotics. The results of the study help to conduct targeted therapy.
- Clinical analysis of blood with a mandatory count of platelets. Thrombocytopenia is considered one of the early signs of septic shock.
- It is desirable to conduct a coagulogram study to determine the presence of the DIC syndrome, its form (acute, chronic) and phase (hypercoagulation, hypocoagulation with local or generalized activation of fibrinolysis). In the absence of such an opportunity, a minimum of studies should be done: platelet count, blood clotting time, plasma fibrinogen level, the presence of soluble complexes of fibrin monomers (FPC) and fibrin and fibrinogen degradation products (PDF), or blood thromboelastography.
Evaluation of the data of clinical observation and laboratory tests allows diagnosing the shock and revealing the degree of disturbance of the function of the sick organism.
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