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