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 |