Definitions of systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, and shock
| (1) Systemic inflammatory response syndrome (SIRS) |
| Systemic inflammatory response to a wide variety of severe clinical insults, manifested by two or more of the following conditions: |
| (i) Oral temperature >38°C or <36°C |
| (ii) Heart rate >90 beats/min |
| (iii) Respiratory rate >20 breaths/min or PaCO2 <32 mm Hg |
| (iv) WBC count >12 000/mm3, <4000/mm3, or >10% immature (band) forms. |
| (2) Sepsis |
| SIRS, as defined above, in response to a proven or suspected microbial event. |
| (3) Severe sepsis/SIRS |
| Sepsis (SIRS) associated with organ dysfunction, hypoperfusion, or hypotension, which may include, but are not limited to |
| lactic acidosis |
| oliguria |
| an acute alteration in mental status. |
| (4) Sepsis (SIRS) induced hypotension |
| Systolic blood pressure <90 mm Hg or a reduction of >40 mm Hg from baseline in the absence of other causes of hypotension. |
| (5) Septic shock/SIRS shock |
| Sepsis (SIRS) induced hypotension despite adequate fluid resuscitation along with organ dysfunction or perfusion abnormalities, as listed above for severe sepsis/SIRS. |
| (6) Refractory septic shock/SIRS shock |
| Sepsis (SIRS) induced shock that lasts for >1 hour and does not respond to fluid and pressor administration. |
| (7) Multiple organ dysfunction syndrome (MODS) |
| Dysfunction of more than one organ, requiring intervention to maintain homeostasis. |