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==Definition==


Sepsis is a systemic, deleterious host response to infection, manifested as multi system organ dysfunction plus hypotension, that is not readily reversible with fluid resuscitation.
==Diagnostic Criteria For Sepsis (Documented/Suspected Infection Plus Inflammatory variables Plus One of The Organ Dysfunction)==
:'''General variables'''
:*Fever > 38.3°C
:*Hypothermia ( core temperature < 36°C )
:*Heart rate > 90/min–1 or > 2 SD above the normal value for age
:*Tachypnea
:*Altered mental status
:*Edema
:*Positive fluid balance ( > 20 mL/kg over 24 hr)
:*Hyperglycemia ( plasma glucose > 140 mg/dL or 7.7 mmol/L ) in the absence of diabetes
:'''Inflammatory variables'''
:*Leukocytosis ( WBC count > 12,000 µL–1 )
:*Leukopenia ( WBC count < 4000 µL–1 )
:*Immature WBCs forms are > 10% with normal count
:*Plasma C-reactive protein > 2 SD above the normal value
:*Plasma procalcitonin > 2 SD above the normal value
:'''Hemodynamic variables'''
:*Arterial hypotension after 30 ml/kg fluid bolus  ( SBP < 90 mm Hg, MAP < 70 mm Hg, or an SBP decrease > 40 mm Hg in adults or < 2 SD below normal for age )
:'''Organ dysfunction variables'''
:*Arterial hypoxemia ( Pao2/Fio2 < 300 )
:*Acute oliguria ( urine output < 0.5 mL/kg/hr for at least 2 hrs despite adequate fluid resuscitation )
:*Creatinine increase > 0.5 mg/dL or 44.2 µmol/L
:*Coagulation abnormalities ( INR > 1.5 or aPTT > 60 Sec )
:*Ileus ( absent bowel sounds )
:*Thrombocytopenia ( platelet count < 100,000 µL–1 )
:*Hyperbilirubinemia ( plasma total bilirubin > 4 mg/dL or 70 µmol/L )
:'''Tissue perfusion variables'''
:*Hyperlactatemia > 1 mmol/L
:*Decreased capillary refill or mottling
==Diagnostic Criteria for Severe Sepsis (sepsis induced hypoperfusion or organ dysfunction)==
Includes any one of the following caused due to the infection:
:* Sepsis-induced hypotension
:* Lactate above upper limits laboratory normal
:* Urine output < 0.5 mL/kg/hr for more than 2 hrs despite adequate fluid resuscitation
:* Acute lung injury with Pao2/Fio2 < 250 in the absence of pneumonia as infection source
:* Acute lung injury with Pao2/Fio2 < 200 in the presence of pneumonia as infection source
:* Creatinine > 2.0 mg/dL (176.8 μmol/L)
:* Bilirubin > 2 mg/dL (34.2 μmol/L)
:* Platelet count < 100,000 μL
:* Coagulopathy (international normalized ratio > 1.5)

Latest revision as of 16:00, 4 March 2014