TABLE 17.2Definitions of Systemic Inflammatory Response Syndrome (SIRS) and Different Degrees of Severity of Sepsis.15

ConditionDescription
SIRSTwo or more of the following conditions:
  • Temperature >38.5°C or <35.0°C;
  • Heart rate of >90 beats/min;
  • Respiratory rate of >20 breaths/min or PaCO2 of <32mmHg; and
  • White blood cell count of >12,000cells/mL, <4000cells/mL, or >10% immature (band) forms
SepsisSIRS in response to documented infection (culture or Gram stain of blood, sputum, urine, or normally sterile body fluid positive for pathogenic microorganism; or focus of infection identified by visual inspection)
Severe sepsisSepsis and at least one of the following signs of organ hypoperfusion or organ dysfunction:
  • Areas of mottled skin;
  • Capillary refilling of >3 seconds;
  • Urinary output of <0.5mL/kg for at least 1 hour or renal replacement therapy; lactate >2mmol/L;
  • Abrupt change in mental status or abnormal EEG findings;
  • Platelet count of <100,000cells/mL or disseminated intravascular coagulation;
  • Acute lung injury/Acute Respiratory Distress Syndrome; and
  • Cardiac dysfunction (echocardiography)
Septic shockSevere sepsis and one of the following conditions:
  • Systemic mean blood pressure (BP) of <60mmHg (<80mmHg if previous hypertension) after 20 to 30mL/kg starch or 40 to 60mL/kg saline solution, or pulmonary capillary wedge pressure (PCWP) between 12 and 20mmHg.
  • Need for dopamine of >5mcg/kg/min, or nor adrenaline or epinephrine of <0.25mcg/kg/min to maintain mean BP at >60mmHg (80mmHg if previous hypertension)
Refractory septic shockNeed for dopamine at >15mcg/kg/min, or nor adrenaline or adrenaline at >0.25mcg/kg/min to maintain mean BP at >60mmHg (80mmHg if previous hypertension)

From: 17, SIRS, Sepsis and Multiorgan Failure

Cover of Mechanisms of Vascular Disease
Mechanisms of Vascular Disease: A Reference Book for Vascular Specialists [Internet].
Fitridge R, Thompson M, editors.
Adelaide (AU): University of Adelaide Press; 2011.
© The Contributors 2011.

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