Early Goal-Directed Therapy (Sepsis) Program
Sepsis Definitions
Sepsis has several definitions that are important to understand, they include: SIRS, Sepsis, Severe Sepsis and Septic Shock.
SIRS
SIRS, or Systemic Inflammatory Response Syndrome is defined as two or more of the following:
- Temperature >38C or <36C
- Respiratory Rate >20 or PaCO2 <32mmHg
- White Blood Cell Count >12,000 or <4,000 or >10% Bands and
- Pulse >90 beats/minute
Sepsis
Sepsis is defined as presence of infection plus SIRS.
Severe Sepsis
Sepsis plus sepsis-induced organ dysfunction (i.e. renal/liver/heart failure) or tissue hypoperfusion.
Sepsis-Induced Hypotension:
Systolic BP <90mmHg or MAP <70mmHg or a systolic BP decrease >40mmHg or <2 SD below normal for age in the absence of other etiologies of low blood pressure
Eligible for Early Goal Directed Therapy
Either Septic Shock -or- SIRS criteria PLUS a Lactate >=4 mmol/l
Septic Shock
Sepsis-induced hypotension persisting despite adequate (20-40 ml/kg bolus of intravenous fluid) fluid resuscitation.
Tissue Hypoperfusion Sepsis-Induced Tissue Hypoperfusion:
Septic shock, elevated lactate or oliguria.