Table 1 Definitions of sepsis
From: Prevalence and incidence of severe sepsis in Dutch intensive care units
Criteria/definition | |
|---|---|
SIRS | Fever or hypothermia (body temperature < 36°C or > 38°C) |
Tachycardia (> 90 beats/min) | |
Tachypnoea (> 20 breaths/min or PaCO2 < 4.3 kPa (32 mmHg) during spontaneous breathing or the need for artificial respiration) | |
Leucocytes > 12000/mm3 or < 4000/mm3 or > 10% immature neutrophils | |
Sepsis | Presence of a confirmed or strongly suspected infection and occurrence of at least two SIRS criteria during the first 24 hours of ICU admission |
Severe sepsis | Sepsis in combination with the occurrence of at least one failing organ system (defined below) within the first 24 hours of ICU admission |
Septic shock | Sepsis in combination with the occurrence of cardiovascular organ failure and metabolic dysfunction (defined below) during the first 24 hours of ICU admission |
Acute organ failure | CNS dysfunction: acute deterioration of neurological condition not attributable to start of sedation or CNS disease in the 24 hours before admission or during the period of observation |
Cardiovascular system dysfunction: systolic blood pressure ≤ 90 mmHg or mean arterial pressure ≤ 70 mmHg for 1 hour, despite adequate fluid resuscitation, or the need to administer vasopressors in order to maintain systolic blood pressure ≥ 90 mmHg or mean arterial pressure ≥ 70 mmHg | |
Kidney failure: urine output < 0.5 ml/kg per hour for at least 1 hour, despite adequate fluid resuscitation, or serum creatinine ≥ 177 μmol/l not attributable to chronic kidney failure | |
Respiratory system dysfunction: a ratio of PaO2 to FiO2 < 26.6 kPa if source of infection was not pulmonary and < 33.2 kPa if infection source was pulmonary, or if mechanical or noninvasive artificial respiration was indicated because of clinical respiratory insufficiency within the first 24 hours of admission | |
Haematological dysfunction: platelet count < 80,000/mm3, or a decrease of at least 50% in the 2 days preceding admission | |
Metabolic dysfunction: metabolic acidosis (pH ≤ 7.30 or base deficit ≥ 5.0 mmol/l) in association with a plasma lactate level > 3.0 mmol/l | |
Liver dysfunction: bilirubin > 43 μmol/l, or ALT (SGPT) > 50 U, or PTT more than 1.5 times normal or INT > 1.5 in the absence of systemic anticoagulant agents |