Table 2.
Sepsis 2.02,3 | CMS4 | Sepsis-3.05 | 2016 SCC Guidelines6 | |
---|---|---|---|---|
SIRS | Temperature > 38°C or < 36°C Heart rate > 90 bpm Respiratory rate > 20 or PaCO2 < 32 mmHg White blood cell count > 12,000/cu mm, < 4,000/cu mm or > 10% bands |
No change | Eliminated. qSOFA introduced Respiratory rate > 22 Altered mental status Systolic blood pressure < 90 mmHg |
No SIRS. No qSOFA. |
Sepsis | Infection and two or more SIRS | No change | Infection and two qSOFA criteria | Infection and end organ dysfunction. No clinical criteria offered. |
Severe Sepsis | Sepsis and end organ dysfunction defined as:
|
Sepsis and end organ dysfunction. Lactate > 2 | Eliminated | Eliminated |
Septic Shock | Sepsis and a SBP < 90 mmHg or a reduction of 40 mm Hg from baseline or evidence of low perfusion after adequate fluid bolus. |
Initial lactate > 4 or SBP < 90 mm Hg after 30 mL/kg fluid bolus | SBP < 90 mmHg AND lactate > 2 after adequate fluid resuscitation | Subset of sepsis with circulatory and cellular/metabolic dysfunction associated with a higher risk of mortality. No clinical criteria offered |
SIRS, systemic inflammatory response syndrome; CMS, Centers for Medicare and Medicaid Services; SCC, Surviving Sepsis Campaign; bpm, beats per minute; cu mm, cubic millimeter; qSOFA, quick sequential organ failure assessment; ml/kg/hr, milliliter per kilogram per hour; PaO2, partial pressure of oxygen; FiO2, fraction of inspired oxygen; INR, international normalized ratio; mg/dL, milligram per deciliter; MAP, mean arterial pressure; SBP, systolic blood pressure.
All lactate levels in millimoles per liter values.