Infection,a documented or suspected, and some of the following: |
General variables |
Fever (core temperature > 38.3˚C) Hypothermia (core temperature < 36˚C) Heart rate > 90 min−1 or >2 SD above the normal value for age Tachypnea Altered mental status Significant edema or positive fluid balance (>20 ml/kg over 24 hrs) Hyperglycemia (plasma glucose > 120 mg/dl or 7.7 mmol/L) in the absence of diabetes |
Inflammatory variables |
Leukocytosis (WBC count > 12000 μL−1) Leukopenia (WBC count < 4000 μL−1) Normal WBC count with > 10% immature forms Plasma CRP > 2SD above the normal value Plasma PCT > 2SD above the normal value |
Hemodynamic variables |
Arterial hypotension (SBP < 90 mmHg, MAP < 70 mmHg, or an SBP decrease > 40 mmHg in adults or 2 SD below normal for age) Svo2 >70% Cardiac index >3.5 L∙min−1∙M−2 |
Organ dysfunction variables |
Arterial hypoxemia (PaO2/FiO2 < 300) Acute oliguria (urine output < 0.5 ml∙kg−1∙hr−1 or 45 mmol/L for at least 2 hrs) Creatinine increase > 0.5 mg/dL Coagulation abnormalities (INR > 1.5 or aPTT > 60 secs) Ileus (absent bowel sounds) Thrombocytopenia (platelet count < 100,000μL−1) Hyperbilirubinemia (plasma total bilirubin > 4 mg/dL or 70 mmol/L) |
Tissue perfusion variables |
Hyperlactatemia (>1 mmol/L) Decreases capillary refill or mottling |