Laboratory examination of septic shock

 Laboratory examination of septic shock

Laboratory examination of septic shock

（1） The white blood cell count of hemogram mostly increased, neutrophils increased, toxic particles and nuclear left shift. Hematocrit and increased hemoglobin are signs of blood concentration. In the late stage of shock, platelet count decreased and coagulation time prolonged, suggesting the occurrence of DIC.

（2） Urine routine can have a small amount of protein, red blood cells and tube type. When acute renal failure occurs, the specific gravity of urine changes from high in the initial stage to low and fixed; The ratio of urine / blood osmotic pressure was less than 1.5; If the ratio of urinary and blood creatinine concentration is less than 10:1, the urinary excretion is normal or high.

（3） For etiological examination, blood, cerebrospinal fluid, urine, stool and purulent focus exudate (including anaerobic culture) were taken for culture before the application of antibiotics. Those with positive culture were tested for drug sensitivity. Limulus lysate test is helpful to detect trace endotoxin.

（4） Blood gas analysis in the early stage of shock, the main manifestations were high arterial blood pH, decreased oxygen partial pressure (PaO2) and unchanged residual base (be). In the late stage of shock, the pH was low, pCO2 decreased and be negative increased.

（5） The blood biochemical examination showed that the blood sodium was low and the blood potassium was different. In the late stage of shock, urea nitrogen and ALT increased, and even hyperbilirubinemia occurred, suggesting the impairment of liver and kidney function.

（6） The main indexes of DIC were platelet count and prothrombin time. Fibrinogen quantification, plasma protamine paracoagulation test, euglobulin dissolution time, thrombin coagulation time. If the first three items are abnormal, the diagnosis of DIC is established. If possible, FDP (fibrinolytic product) can be detected quickly. If it exceeds normal, it reflects intravascular hemolysis (secondary fibrinolysis).