Consensus definitions for sepsis and septic shock have been revised for the first time since 2001 and published jointly by the Society of Critical Care Medicine and the European Society of Intensive Care Medicine in the February 23 issue of JAMA.
Sepsis should be defined as life-threatening organ dysfunction caused by a dysregulated host response to infection.
For clinical operationalization, organ dysfunction can be represented by an increase in the SOFA score of 2 points or more.
Septic shock should be defined as a subset of sepsis in which particularly profound circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone.
Septic shock can be clinically identified by a vasopressor requirement to maintain a mean arterial pressure of 65 mm Hg or greater and serum lactate level greater than 2 mmol/L (>18 mg/dL) in the absence of hypovolemia.
Adult patients with suspected infection can be rapidly identified as being more likely to have poor outcomes if they have at least 2 of the following criteria in a new score called quickSOFA (qSOFA): respiratory rate of 22/min or greater, altered mentation, or systolic blood pressure of 100 mm Hg or less.