Table 1.
Revised Definitions of Sepsis
| 1992 Consensus Statement [7] | Sepsis-3 [11] | |
|---|---|---|
| SIRS | Four Criteria of SIRS | Eliminated |
| Temperature >38°C or <36°C | ||
| Heart rate >90 beats per minute | ||
| Respiratory rate >20 breaths per minute or PaCO2 < 32 mm Hg | ||
| White blood cell count >12,000/cu mm, <4,000/cu mm or 10% bands | ||
| Sepsis | Systemic response to infection, manifested by two or more SIRS criteria | Life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunction defined as an increase in 2 points or more in the SOFA score, which includes respiration, coagulation, liver function, hypotension, altered mental status, and kidney dysfunction. |
| ICU patients with increased risk of mortality or prolonged ICU stay can be identified with a qSOFA score >2: | ||
| Altered mental status; Glasgow Coma Scale <15 | ||
| Respiratory rate >22 breaths per minute | ||
| Systolic blood pressure <100 mm Hg | ||
| Severe sepsis | Sepsis associated with organ dysfunction, hypoperfusion, or hypotension. Hypoperfusion and perfusion abnormalities may include, but are not limited to lactic acidosis, oliguria, or an acute alteration in mental status | Eliminated |
| Septic shock | Sepsis-induced hypotension despite adequate fluid resuscitation, along with the presence of perfusion abnormalities that may include, but are not limited to, lactic acidosis, oliguria, or an acute alteration in mental status. Patients who are receiving inotropic or vasopressor agents may not be hypotensive at the time that perfusion abnormalities are measured | Subset of sepsis in which underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality. |
| Criteria: | ||
| Sustained systolic blood pressure <90 mm Hg requiring vasopressors to maintain mean arterial pressure >65 mm Hg, and | ||
| Lactate >2 mmol/L, despite adequate volume resuscitation |
SIRS = systemic inflammatory response syndrome; PaCO2= partial pressure of carbon dioxide ; SOFA = Sequential [Sepsis-related] Organ Failure Assessment; qSOFA = Quick Sequential Organ Failure Assessment; ICU = intensive care unit;