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Definition of Severe Sepsis by the Surviving Sepsis Guidelines
Severe sepsis is sepsis (known or suspected infection with systemic manifestations of sepsis) along with sepsis-related tissue hypoperfusion or organ dysfunction. Organ dysfunction or tissue hypoperfusion are defined by the Surviving Sepsis Campaign as any of the below signs or findings:
Signs of Severe Sepsis: Organ Dysfunction / Tissue Hypoperfusion
- Hypotension from sepsis (systolic blood pressure < 90 mm Hg, mean arterial pressure < 70 mm Hg, or a decrease in SBP by > 40 mm Hg)
- Elevated lactate (above upper limit of normal)
- Decreased urine output (<0.5 ml/kg/hr for more than 2 hours despite fluid resuscitation)
- Acute lung injury / ARDS (if no pneumonia present: PaO2/FiO2 < 250; if pneumonia present: PaO2/FiO2 < 200)
- Creatinine > 2 mg/dL
- Total Bilirubin > 2 mg/dL
- Thrombocytopenia (platelet count < 100,000)
- Coagulopathy (INR > 1.5)
To be considered signs of severe sepsis, these findings must be due to sepsis, not a pre-existing condition. They must also persist despite adequate fluid resuscitation. Two liters of crystalloid are proposed as adequate fluid resuscitation in severe sepsis for most people; volume-depleted patients (often including the elderly and/or those suffering days of illness before presenting) may require several liters of crystalloid as volume resuscitation to be considered "adequate."
PulmCCM is not affiliated with the Surviving Sepsis Campaign or the Surviving Sepsis Guidelines.