Surviving Sepsis Guidelines' Criteria for Sepsis Diagnosis
See all the Surviving Sepsis Guidelines
PulmCCM is not affiliated with the Surviving Sepsis Guidelines or the Surviving Sepsis Campaign which is at http://www.survivingsepsis.org. According to the Surviving Sepsis Guidelines, a sepsis diagnosis requires the presence of infection, which can be proven or suspected, and 2 or more of the following criteria:
Hypotension (systolic blood pressure < 90 mm Hg or fallen by >40 from baseline, mean arterial pressure < 70 mm Hg)
Lactate > 1 mmol/L
Mottled skin
Decreased capillary refill of nail beds or skin
Fever > 38.3 degrees C, or 101 degrees F
Hypothermia < 36 degrees C core temperature (<96.8 degrees F)
Heart rate > 90
Tachypnea
Change in mental status
Significant edema or positive fluid balance (>20 mL/kg over 24 hours)
Hyperglycemia (>140 mg/dL) in someone without diabetes
White blood cell count > 12,000 or less than 4,000, or with >10% "bands" (immature forms)
Elevated C-reactive protein in serum (according to your lab's cutoffs)
Elevated procalcitonin in serum (according to your lab)
Arterial hypoxemia (paO2 / FiO2 < 300)
Acute drop in urine output (<0.5 ml/kg/hr for at least 2 hours despite fluid resuscitation, or about 35 ml/hour for a 70 kg person)
Creatinine increase > 0.5 mg/dL
INR > 1.5 or aPTT > 60 seconds
Absent bowel sounds (ileus)
Platelet count < 100,000
High bilirubin (total bilirubin > 4 mg/dL
The definition of severe sepsis is sepsis with impaired blood flow to body tissues (hypoperfusion) or detectable organ dysfunction. Severe sepsis may occur with or without sepsis-induced hypotension (e.g., with fever, encephalopathy and renal failure but a normal blood pressure). The definition of septic shock is severe sepsis with sepsis-induced hypotension [systolic blood pressure < 90 mm Hg (or a drop of > 40 mm Hg from baseline) or mean arterial pressure < 70 mm Hg] that persists after adequate fluid resuscitation. "Adequate" is determined by the estimation of the patient's pre-sepsis intravascular volume status.