Sepsis & septic shock

Question 1

What is the definition of SIRS?

Answer 1

Two or more of:

• Temperature (T) > 38 or < 36
• Heart rate (HR) > 90 bpm
• Respiratory rate (RR) > 20 bpm, OR PaCO2 < 32 mmHg (4.3 kPa)
• White blood cell (WBC) > 12 or < 4, or > 10% immature bands

Occurring in the presence of an infective source.

Question 2

What is the definition of sepsis?

Answer 2

• Life-threatening organ dysfunction caused by a dysregulated host response to infection, clinically identified as:
• acute increase in the Sequential [previously called Sepsis-related] Organ Failure Assessment (SOFA) score of ≥ 2 points, consequent to the infection

Question 3

What is the definition of septic shock?

Answer 3

A subset of sepsis, in which particularly profound circulatory, cellular, and metabolic abnormalities are a/w a greater risk of mortality than with sepsis alone, clinically identified as:

• Requiring vasopressors to maintain a mean arterial pressure (MAP) ≥ 65 mmHg, AND
• Serum lactate > 2 mmol/L,
• In the absence of hypovolaemia (i.e. despite adequate fluid resuscitation)