ABSTRACT
American College of Chest Physicians/Society of Critical Care Medicine Consensus ▲ Infection-inflammatory response to microorganisms ▲ Bacteremia-presence of viable bacteria in blood ▲ Systemic inflammatory response syndrome (SIRS)—
inflammatory response to various insults • Is defined by ≥2 of the following:
– Temperature >38°C or <36°C – Heart rate >90 beats/min – Respiratory rate >20 beats/min or PaCO2 <32 mm Hg – WBC >10,000/mm3 (>10 × 109/L) or <4,000/mm3
(>4 × 109/L), >10% immature band forms ▲ Sepsis-infection plus SIRS ▲ Multiorgan dysfunction syndrome-inflammatory-medi-
ated injury involving several organ systems in an acutely ill patient such that homeostasis cannot be maintained without intervention
▲ Severe sepsis-sepsis plus multiorgan system dysfunction ▲ Septic shock-severe sepsis plus hypotension refractory
to fluids (systolic blood pressure <90 mm Hg or a decrease of ≥40 mm Hg from baseline in absence of other causes of hypotension plus hypoperfusion abnormalities, e.g., oliguria, lactic acidosis, acute change in mental status)
EPIDEMIOLOGY ■ Incidence/prevalence in U.S.—176/100,000 persons/year
▲ In U.S., at least 750,000 cases/year, and 225,000 are fatal.
