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