Table 1 |
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|
Definitions of sepsis |
|
| 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 |
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ALT, alanine aminotransferase; PaCO2, arterial carbon dioxide tension; CNS, central nervous system; FiO2, fractional inspired oxygen; ICU, intensive care unit; SGPT, serum glutamate-pyruvate transaminase; SIRS, systemic inflammatory response syndrome. |
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van Gestel et al. Critical Care 2004 8:R153 doi:10.1186/cc2858 |
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