UMEM Educational Pearls

Title: Sepsis-3

Posted: 2/24/2016 by Mike Winters, MBA, MD
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Sepsis-3

After nearly 2 decades, the definitions for sepsis and septic shock have been updated.
Key findings from the Task Force convened by SCCM and ESICM include:
- Sepsis
  - Definition: life-threatening organ dysfunction due to a dysregulated host response to infection
  - ICU patients: organ dysfunction is defined as an increase of 2 points or more in the Sequential Organ Failure Assessment (SOFA) score
  - ED patients: 2 or more of the following new qSOFA (quickSOFA) score may identify patients with increased mortality
    - SBP less than or equal to 100 mm Hg
    - RR greater than or equal to 22
    - Altered mental status
- Septic Shock
  - Definition: a subset of patients with sepsis and profound circulatory, cellular, and metabolic abnormalities
  - Clinical Criteria:
    - Persistent hypotension requiring vasopressors to maintain MAP greater than or equal to 65 mm Hg despite adequate volume resuscitation
    - Lactate greater than or equal to 2 mmol/L
- The term "severe sepsis" is no longer used

Singer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016; 315:801-10.