{"id":2509,"date":"2009-03-08T12:23:34","date_gmt":"2009-03-08T12:23:34","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/infsepsis\/"},"modified":"2025-05-14T19:10:24","modified_gmt":"2025-05-14T19:10:24","slug":"infsepsis","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/infsepsis\/","title":{"rendered":"Diagnostic Criteria for Sepsis"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Infection,<em><sup>a<\/sup> <\/em>documented or suspected, and some of the following:<em><sup>b<\/sup><\/em><\/p>\n<p><!--more--><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">General variables<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Fever (core temperature &gt;38.3 \u00b0C)<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Hypothermia (core temperature &lt;36 \u00b0C)<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Heart rate &gt;90 \/min or &gt;2 SD above the normal value for age<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Tachypnea<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Altered mental status<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Significant edema or positive fluid balance (&gt;20 mL\/kg over 24 hrs)<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Hyperglycemia (plasma glucose &gt;120 mg\/dL or 7.7 mmol\/L) in the absence of diabetes<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Inflammatory variables<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Leukocytosis (WBC count &gt;12,000 \/mm<sup>3<\/sup>)<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Leukopenia (WBC count &lt;4000 \/mm<sup>3<\/sup>)<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Normal WBC count with &gt;10% immature forms<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Plasma C-reactive protein &gt;2 SD above the normal value<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Plasma procalcitonin &gt;2 SD above the normal value<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Hemodynamic variables<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Arterial hypotension<em><sup>b<\/sup> <\/em>(SBP &lt;90 mm Hg, MAP &lt;70, or an SBP decrease &gt;40 mm Hg in adults or &lt;2 SD below normal for age)<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>SvO<sub>2<\/sub> &gt;70%<em><sup>b<\/sup><\/em><\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Cardiac index (CI) &gt;3.5 L.min<sup>-1<\/sup>.M<sup>-23<\/sup><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Organ dysfunction variables<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Arterial hypoxemia (PaO<sub>2<\/sub>\/FIO<sub>2<\/sub> &lt;300)<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Acute oliguria (urine output &lt;0.5 mL.kg<sup>-1<\/sup>.hr<sup>-1<\/sup> or 45 mmol\/L for at least 2 hrs)<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Creatinine increase &gt;0.5 mg\/dL<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Coagulation abnormalities (INR &gt;1.5 or aPTT &gt;60 secs)<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Ileus (absent bowel sounds)<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Thrombocytopenia (platelet count &lt;100,000 \/mm<sup>3<\/sup>)<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Hyperbilirubinemia (plasma total bilirubin &gt;4 mg\/dL or 70 mmol\/L)<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Tissue perfusion variables<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Hyperlactatemia (&gt;1 mmol\/L)<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 27pt; text-indent: -18pt; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>Decreased capillary refill or mottling<\/p>\n<p>&nbsp;<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">WBC, white blood cell; SBP, systolic blood pressure; MAP, mean arterial blood pressure; SvO<sub>2<\/sub>, mixed venous oxygen saturation; INR, international normalized ratio; aPTT, activated partial thromboplastin time.<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><em><sup><br \/>\na<\/sup><\/em>Infection defined as a pathologic process induced by a microorganism;<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><em><sup>b<\/sup><\/em>SvO2 sat &gt;70% is normal in children (normally, 75\u201380%), and CI 3.5\u20135.5 is normal in children; therefore, NEITHER should be used as signs of sepsis in newborns or children;<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><em><sup>c<\/sup><\/em>diagnostic criteria for sepsis in the pediatric population are signs and symptoms of inflammation plus infection with hyper- or hypothermia (rectal temperature &gt;38.5 or &lt; 35 \u00b0C), tachycardia (may be absent in hypothermic patients), and at least one of the following indications of altered organ function: altered mental status, hypoxemia, increased serum lactate level, or bounding pulses.<\/p>\n<div class=\"Section1\">\n<div class=\"Section1\">\n<div class=\"Section1\">\n<div class=\"Section1\">\n<div class=\"Section1\">\n<div class=\"Section1\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<p class=\"MsoNormal\"><strong>References:<\/strong><\/p>\n<ol style=\"margin-top: 0cm;\">\n<li>Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, Cohen J, Opal SM, Vincent JL, Ramsay G; SCCM\/ESICM\/ACCP\/ATS\/SIS. 2001 SCCM\/ESICM\/ACCP\/ATS\/SIS International Sepsis Definitions Conference.\u00a0Crit Care Med. 2003 Apr;31(4):1250-6.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/12682500\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<li>Angus DC, van der Poll T. Severe sepsis and septic shock. N Engl J Med. 2013 Aug 29;369(9):840-51.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/23984731\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created: Aug 02, 2005.<br \/>\nUpdate: Sep 28, 2014.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[39],"tags":[16,15,14,13,1344,1562],"class_list":["post-2509","post","type-post","status-publish","format-standard","hentry","category-infetious-disease","tag-criteria","tag-criterios","tag-diagnostic","tag-diagnostico","tag-infectious","tag-sepsis"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2509","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2509"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2509\/revisions"}],"predecessor-version":[{"id":9141,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2509\/revisions\/9141"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2509"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2509"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2509"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}