UMEM Educational Pearls

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

References

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