Definitions Used to Describe the Condition of Septic Patients

Bacteremia Presence of bacteria in blood, as evidenced by positive blood cultures Septicemia Presence of microbes or their toxins in blood Systemic inflammatory response syndrome (SIRS) Two or more of the following conditions: (1) fever (oral temperature >38°C) or hypothermia (<36°C); (2) tachypnea (>24 breaths/min); (3) tachycardia (heart rate >90 beats/min); (4) leukocytosis (>12,000/µL), leukopenia (<4,000/µL), or >10% bands; may have a noninfectious etiology Sepsis SIRS that has a proven or suspected microbial etiology Severe sepsis (similar to "sepsis syndrome") Sepsis with one or more signs of organ dysfunction—for example: 1. Cardiovascular: Arterial systolic blood pressure ≤ 90 mmHg or mean arterial pressure ≤ 70 mmHg that responds to administration of intravenous fluid 2. Renal: Urine output <0.5 mL/kg per hour for 1 h despite adequate fluid resuscitation 3. Respiratory: PaO2/FIO2 ≤250 or, if the lung is the only dysfunctional organ, ≤200 4. Hematologic: Platelet count <80,000/µL or 50% decrease in platelet count from highest value recorded over previous 3 days 5. Unexplained metabolic acidosis: A pH ≤7.30 or a base deficit ≥ 5.0 mEq/L and a plasma lactate level >1.5 times upper limit of normal for reporting lab 6. Adequate fluid resuscitation: Pulmonary artery wedge pressure ≥ 12 mmHg or central venous pressure ≥ 8 mmHg Septic shock Sepsis with hypotension (arterial blood pressure <90 mmHg systolic, or 40 mmHg less than patient's normal blood pressure) for at least 1 h despite adequate fluid resuscitation; or Need for vasopressors to maintain systolic blood pressure ≥ 90 mmHg or mean arterial pressure ≥ 70 mmHg Refractory septic shock Septic shock that lasts for >1 h and does not respond to fluid or pressor administration Multiple-organ dysfunction syndrome (MODS) Dysfunction of more than one organ, requiring intervention to maintain homeostasis

Referensi : Harrison's Principles of Internal Medicine 17th Edition (McGraw-Hill) 2008

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