Sepsis-2: More than the SIRS Criteria

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Table 1. Diagnostic criteria for Sepsis
Infection, documented or suspected, and some of the following:

General variables
• Fever (> 38.3°C)
• Hypothermia (core temperature < 36°C)
• Heart rate > 90/min–1 or more than two sd above the normal value for age
• Tachypnea
• Altered mental status
• Significant edema or positive fluid balance (> 20mL/kg over 24hr)
• Hyperglycemia (plasma glucose > 140mg/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)
• Normal WBC count with greater than 10% immature forms
• Plasma C-reactive protein more than two sd above the normal value
• Plasma procalcitonin more than two sd above the normal value

Hemodynamic variables
• Arterial hypotension (SBP < 90mm Hg, MAP < 70mm Hg, or an SBP decrease > 40mm Hg in adults or less than two sd below normal for age)

Organ dysfunction variables
• Arterial hypoxemia (Pao2/Fio2 < 300)
• Acute oliguria (urine output < 0.5mL/kg/hr for at least 2 hrs despite adequate fluid resuscitation)
• Creatinine increase > 0.5mg/dL or 44.2 µmol/L
• Coagulation abnormalities (INR > 1.5 or aPTT > 60 s)
• Ileus (absent bowel sounds)
• Thrombocytopenia (platelet count < 100,000 µL–1)
• Hyperbilirubinemia (plasma total bilirubin > 4mg/dL or 70 µmol/L)

Tissue perfusion variables
• Hyperlactatemia (> 1 mmol/L)
• Decreased capillary refill or mottling

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