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diagnostic criteria for sepsis
Diagnostic criteria:
- infection or suspected infection & some of the following
- general
- fever > 38.3 C
- hypothermia: core temperature < 36.0 C
- heart rate > 90
- tachypnea
- altered mental status
- edema or positive fluid balance (> 20 mL/kg over 24 hours)
- hyperglycemia (plasma glucose > 140 mg/dL) in absence of diabetes mellitus
- inflammation
- leukocytosis: leukocyte count > 12,000/uL
- leukopenia: leukocyte count < 4000/uL
- > 10% immature leukocytes
- elevated serum C-reactive protein
- elevated serum procalcitonin
- hemodynamic instability
- arterial hypotension
- systolic BP < 90 mm Hg
- mean arterial pressure < 70 mmg Hg
- organ dysfunction
- arterial hypoxemia: PaO2/FiO2 < 300 mm Hg
- acute oliguria: urine output < 0.5 mg/kg over 2 hours despite adequate hydration
- serum creatinine increase of > 0.5 mg/dL
- INR > 1.5 or aPTT > 60 seconds
- ileus
- thrombocytopenia: platelet count < 100,000/uL
- hyperbilirubinemia: serum total bilirubin > 4 mg/dL
- inadequate tissue perfusion
- increased plasma lactate (> 1 mmol/L)
- decreased capillary refill
- mottling
General
criteria
References
- Medical Knowledge Self Assessment Program (MKSAP) 17, 18.
American College of Physicians, Philadelphia 2015, 2018.