VAROVNÉ PŘÍZNAKY PŘEDCHÁZEJÍCÍ ROZVOJSEPTICKÉHO ŠOKU U NEUTROPENICKÝCH NEMOCNÝCHLÉČENÝCH PRO HEMATOLOGICKÉ MALIGNITY

Warning Symptoms Preceding the Development of Septic Shock inNeutropenic Patients Treated on Acoount of Haematological Malignities

Background.
In patients with haematological malignities infectious complications take a very rapid course, andin particular during the period of neutropenia, they are not necessarily manifested by a clear symptomatology.Frequently they may be manifested only by an elevated temperature and general deterioration of the condition. Theonset of shock then can be rapid and surprising. The objective of the work was to identify clinical and laboratorysigns warning against the possible development of septic shock.Methods and Results. The investigation comprised a total of 38 patients hospitalised due to infectious compli-cations at the intensive care unit because of general deterioration of the condition. 18 developed septic shock (groupS), the remaining 20 (group N) achieved during hospitalisation at the ICU a stabilised condition. In both groups thelaboratory values and clinical condition were followed up for 2-3 days prior to deterioration of the condition. Riskfactors for development of septic shock in the group of investigated patients were: unusual weakness, heart rateabove 95/min. beyond the temperature peak, hypoalbuminaemia, mucositis, hypokalaemia, presence of a centralvenous catheter and administration of parenteral nutrition.

Key words:
septic shock, risk factors, oncohaematological disease.