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Table 2 Organ dysfunction criteria for the diagnosis of severe sepsis (excerpted from [455])

From: The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016)

Cardiovascular system
Despite the infusion of ≥40 mL/kg of fluid for 1 hour, presentation of:
 ▪ Hypotension
 ▪ Use of vascular inotropic drugs to maintain blood pressure
 ▪ Any two of the following conditions: metabolic acidosis, high serum lactate level, oliguria, prolonged capillary refill time (CRT), or central/peripheral temperature discrepancy
Respiratory system
 ▪ PaO2/FiO2 ratio < 300
 ▪ PaCO2 > 65 Torr or increase from the standard value by 20 Torr
 ▪ ≥ 92% SpO2 despite maintenance of FiO2 > 0.5
 ▪ Need for mechanical ventilation requiring tracheal intubation, or noninvasive positive pressure ventilation
Nervous system
 ▪ Score of ≤11 on the Glasgow Coma Scale (GCS)
 ▪ Acute changes in state of consciousness (fall of ≥3 on the GCS)
Coagulatory function
 ▪ Platelet count under 80,000/μL or 50% decrease in 3-day peak platelet count
 ▪ Prothrombin time-international normalized ratio (PT-INR) > 2
Renal function
 ▪ Two-fold or higher serum creatinine value compared with the normal upper limit creatinine value applicable to the age group or two-fold increase from the typical creatinine value
Hepatic function
 ▪ Total bilirubin ≥ 4 mg/dL
 ▪ Two-fold or higher alanine aminotransferase (ALT) level compared to the normal upper limit applicable to the age group