Table 10.13-2. Clinical consequences and diagnostic features of sepsis

Infection (documented or suspected) and some of the following:

General variables

– Fever >38.3°C or hypothermia <36°C

– Tachycardia >90/min

– Tachypnea >30/min (or mechanical ventilation)

– Sudden deterioration of mental status

– Significant edema or positive fluid balance (>20 mL/kg/d)

– Hyperglycemia (>7.7 mmol/L [140 mg/dL]) in the absence of diabetes

Inflammatory variables

– Leukocytosis (WBC count >12×109/L) or leukopenia (WBC count <4×109/L)

– More than 10% of immature neutrophil forms in WBC differential counts

– Plasma CRP >2 SD above mean value

– Plasma procalcitonin >2 SD above mean value

Hemodynamic and tissue perfusion variables

– Arterial hypotension (SBP <90 mm Hg, MAP <70 mm Hg, or SBP drop >40 mm Hg)

– Serum lactate levels >ULN

– Decreased capillary refill

Emerging or worsening organ dysfunction variables

– Hypoxemia (PaO2/FiO2 <300 mm Hg; <200 mm Hg in patients with primary diseases of the respiratory tract)

– Acute oliguria (urine output <0.5 mL/kg/h over >2 hours with adequate volume status)

– Increase in creatinine levels by ≥44.2 micromol/L (≥0.5 mg/dL) over 48 hours

– Coagulation abnormalities (platelet count <100×109/L, INR >1.5, aPTT >60 seconds)

– Total serum bilirubin levels >70 micromol/L (4 mg/dL)

– Ileus (absent bowel sounds)

Adapted from Crit Care Med. 2013;41(2):580-637.

aPTT, activated partial thromboplastin time; CRP, C-reactive protein; INR, international normalized ratio; MAP, mean arterial pressure; SBP, systolic blood pressure; SD, standard deviation; ULN, upper limit of normal; WBC, white blood cell.