Diagnostic criteria for sepsis

Question 1

General variables in sepsis

Answer 1

• Fever (>38ºC)
• Hypothermia (core temperature 100 beats per minute)
• Tachypnoea (>20 breaths per minute)
• Impaired mental state
• Significant oedema or positive fluid balance (>20ml/kg over 24 hours)
• Hyperglycaemia in the absence of diabetes (plasma glucose >7.7 mmol/l)

Question 2

Inflammatory variables in sepsis

Answer 2

• White blood cell (WBC) count >12 x 109/l (note that a transient leucocytosis is common in labour)
• Leucopenia (WBC count 10% immature forms
• Plasma C-reactive protein >7mg/l

Question 3

Haemodynamic variables in sepsis

Answer 3

• Arterial hypotension (systolic blood pressure 40mmHg)

Question 4

Tissue perfusion variables in sepsis

Answer 4

• Raised serum lactate ≥ 4 mmol/l

- Decreased capillary refill or mottling

Question 5

Organ dysfunction variables in sepsis

Answer 5

• Arterial hypoxaemia (PaO2 /FIO2 44.2μmol/l. Sepsis is severe if creatinine level >176μmol/l
• Coagulation abnormalities ( [INR] >1.5 or [APTT] >60s)
• Thrombocytopaenia (platelet count 70μmol/l)
• Ileus (absent bowel sounds)