Source: Kang-Birken SL. Sepsis and septic shock. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861§ionid=133893876. Accessed May 22, 2017.
TABLE 1.Definitions Related to Sepsis ||Download (.pdf) TABLE 1. Definitions Related to Sepsis
|Condition ||Definition |
|Bacteremia (fungemia) ||Presence of viable bacteria (fungi) in the bloodstream |
|Infection ||Inflammatory response to invasion of normally sterile host tissue by the microorganisms |
|Systemic inflammatory response syndrome ||Systemic inflammatory response to variety of clinical insults that can be infection but also of noninfectious etiology. Response manifested ≥2 of following conditions: temperature >38°C (100.4°F) or <36°C (96.8°F); heart rate >90 beats/min; respiratory rate >20 breaths/min or PaCO2 <32 torr; WBC >12,000 cells/mm3, <4000 cells/mm3, or >10% immature (band) forms. |
|Sepsis || |
SIRS secondary to suspected or documented infection.
Additional criteria include general variables (altered mental status, positive fluid balance of >20 mL/kg over 24 hours, hyperglycemia >120 mg/dL [>6.7 mmol/L]); inflammatory variables (plasma C-reactive protein/procalcitonin >2 SD above normal value); hemodynamic variables (arterial hypotension <90 mm Hg (<12.0 kPa) or MAP <70 mm Hg (<9.3 kPa), elevated mixed venous oxygen saturation of >70% (>0.70); CI >3.5 L/min (>0.058 L/s); organ-dysfunction variables (arterial hypoxemia; acute oliguria of <0.5 mL/kg/h or 45 mL/h for at least 2 h, creatinine increase >0.5 mg/dL (>0.44 μmol/L), coagulation abnormalities, paralytic ileus, platelets <100,000 /mm3 (<100 × 109/L), bilirubin >4 mg/dL (>68 μmol/L); tissue-perfusion variable (hyperlactatemia >1 mmol/L, decreased capillary refill)
|Severe sepsis ||Sepsis associated with one or more organ dysfunctions, hypoperfusion, or hypotension. Hypoperfusion and perfusion abnormalities may include, but are not limited to, arterial hypoxemia (PaO2/FiO2<300) lactic acidosis, oliguria, increase in creatinine, coagulation abnormalities (INR>1.5), and elevated bilirubin |
|Septic shock ||Sepsis with persistent hypotension despite fluid resuscitation (intravenous uid of 30 mL/kg) or hyperlactatemia >1 mmol/L |