How is septic shock diagnosed?
Nov 25, 2025
Source: Cainiu Health
Dr. Wang Lei
Introduction
In general, the diagnosis of septic shock primarily involves evaluating evidence of infection, monitoring vital signs, assessing tissue perfusion, conducting laboratory tests, and determining organ function. When suspected symptoms appear, rapid diagnostic procedures should be initiated promptly to save time for life-saving interventions. A fast, multidisciplinary approach during diagnosis is essential to avoid missing critical indicators. Close monitoring is necessary for patients with severe infections in daily clinical practice.
Generally, the diagnosis of septic shock mainly involves evaluating evidence of infection, monitoring vital signs, assessing tissue perfusion, testing laboratory parameters, and determining organ function. When suspected symptoms appear, rapid diagnostic procedures should be initiated promptly to save critical time for resuscitation. The specific analysis is as follows:
1. Evaluate Evidence of Infection
Septic shock is triggered by severe infection, so identifying an infectious source—such as pneumonia or urinary tract infection—is essential. Combining patient history with imaging examinations, and testing complete blood count, C-reactive protein, and other markers, helps confirm the presence and severity of infection.
2. Monitor Vital Signs
The key indicator is blood pressure; clinicians should be alert if systolic blood pressure drops below 90 mmHg or decreases by more than 40 mmHg from baseline. Increased heart rate, rapid breathing, and abnormal body temperature should also be monitored, as these are typical manifestations of shock.
3. Assess Tissue Perfusion
Inadequate tissue perfusion is a key feature. It can be assessed by observing reduced urine output, cold and clammy skin with cyanosis, altered mental status, and prolonged capillary refill time, all of which indicate impaired perfusion.
4. Test Laboratory Parameters
Arterial blood gas analysis may reveal metabolic acidosis, while elevated lactate levels suggest tissue hypoxia. Abnormalities in coagulation profiles, liver function, and kidney function tests also help assess the severity of shock.
5. Determine Organ Function
Shock often leads to multiple organ dysfunction, necessitating evaluation of heart, lung, kidney, and other organ functions. If complications such as respiratory failure or acute kidney injury occur, septic shock can be confirmed when combined with other clinical indicators.
Multidisciplinary collaboration and rapid integration of various tests are crucial during diagnosis to avoid missing key indicators. For patients with severe infections, close monitoring is necessary in daily care. Immediate emergency protocols should be initiated upon signs such as decreased blood pressure or altered consciousness. During treatment, ensure airway patency, provide nutritional support, and closely monitor changes in vital signs.
