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. Author manuscript; available in PMC: 2012 May 15.
Published in final edited form as: J Surg Res. 2010 Dec 30;167(2):306–315. doi: 10.1016/j.jss.2010.11.923

Table 2.

Sepsis and Related Definitions

Systemic
Inflammatory
Response
Syndrome (SIRS)		 The systemic inflammatory response to a variety of severe clinical
insults. Response includes two or more of the following clinical
conditions:

  • Temperature >38°C or <36°C

  • Heart rate >90 beats per minute

  • Respiratory rate > 20 breaths per minute or PaCO2 < 32 mmHg

  • White blood cell count >12,000/cu mm, < 4,000/cu mm or >10% immature (band) forms.
Sepsis The systemic response to infection, manifested by two or more of
the above clinical criteria listed under SIRS
Severe Sepsis Sepsis associated with an acute organ dysfunction:

  • Neurologic: GCS1 <13 upon recognition of sepsis or deteriorating to <13 during the first 24 hours of sepsis

  • Pulmonary: PaO2/FiO2 ratio <250 (<200 if lung is primary source of infection) and PCWP2 (if available) not suggestive of fluid overload

  • Renal- One of the following: 1) UOP3 < 0.5 ml/kg for ≥ 1hour despite adequate volume resuscitation, 2) Increase in serum creatinine ≥ 0.5 mg/dl from baseline (measured within 24 hours of starting sepsis resuscitation) despite adequate volume resuscitation, 3) increase in serum creatinine ≥ 0.5 mg/dl during the first 24 hours despite adequate volume resuscitation4

  • Coagulation- One of the following: 1) INR > 1.5, 2) Platelet count <80,000 or ≥ 50% decrease platelet count in 24 hour period in the absence of chronic liver disease

  • Hypoperfusion: Lactate level> 4 mmol/L
Septic Shock Sepsis-induced hypotension despite adequate volume resuscitation
along with the presence of perfusion abnormalities (as above);
patients requiring inotropic or vasopressor medications may not be
hypotensive at the time when perfusion abnormalities are
measured.
Sepsis-induced
Hypotension		 Systolic blood pressure <90 mmHg or a reduction of ≥ 40 mmHg
from baseline in the absence of other causes of hypotension.
1

GCS = Glasgow Coma Score

2

PCWP = Pulmonary Capillary Wedge Pressure

3

UOP = Urine Output

4

Adequate volume resuscitation defined by a minimum intravenous fluid infusion of 20 ml/kg/ideal body weight or central venous pressure ≥ 8 mm Hg or PCWP ≥ 12 mm Hg