Sepsis Syndrome

Screening Criteria - at least one of the following:

(1) all 4 of the following

(1a) temperature > 38.3 ° C or < 35.6° C rectally

(1b) respirations > 20 per minute or on mechanical ventilation

(1c) heart rate > 90 beats per minute

(1d) clinical evidence of infection

(2) one or more positive blood cultures positive for pathogen at 48 hours.

Confirmatory Criteria - at least one of the following, without alternative explanation:

(1) PaO2/FIO2 < 280 (intubated) or 40% face mask in use (nonintubated)

(2) arterial pH < 7.30

(3) urine output < 30 mL/h

(4) systolic blood pressure < 90 mm Hg or fall in systolic blood pressure > 40 mm Hg sustained for 2 hours despite fluid challenge

(5) systemic vascular resistance < 800 dynes•s•cm(-5)

(6) prothrombin time or partial thromboplastin time greater than normal or platelet count < 100,000 per µL or platelets decreased to < 50% of most recent measurement before current day

(7) documentation of deterioration in mental status within 24 hours

The mortality rate was 34% at 28 days and 45% at 5 months.