| DESCRIPTION |
Definition Revised (2014):
drainage, ruptured bowel with free air, etc.); a positive culture
from any site thought to be causative; or specialized laboratory
evidence of causative infection (such as viral DNA in blood).
AND
the presence of two or more of the following systemic responses:
Temperature > 38 degrees C or < 36 degrees C
HR > 90 beats/minute
RR > 20 breaths /minute or PaCO2 < 32 mmHg
WBC > 12,000 cell/mm3, < 4,000cells/mm3, or > 10% immature
neutrophils ("bands")
Sepsis is a vast clinical entity that takes a variety of forms. The
o Severe Sepsis/Septic Shock: Sepsis is considered severe when it
is associated with organ and/or circulatory dysfunction.
Terminology such as Severe Sepsis/Septic Shock/Refractory Septic
Shock/Refractory Septic Shock and Multiple Organ Dysfunction
Syndrome (MODS) all fall into this category.
Answer YES if the definition of SEPSIS is present AND there is
documented organ and/or circulatory dysfunction defined by one or more
of the following:
spectrum of disorders spans from relatively mild physiologic
- Areas of acutely mottled skin not related to peripheral vascular
disease
- Capillary refilling requires three seconds or longer not
related to peripheral vascular disease
- Urine output <0.5 mL/kg for at least one hour, or renal
replacement therapy
- Lactate >2 mmol/L
- Abrupt change in mental status
- Abnormal EEG findings
- Platelet count < 100,000 platelets/mL
abnormalities to septic shock. Please report the most significant level
- Disseminated intravascular coagulation (DIC)
- Acute lung injury or acute respiratory distress syndrome (ARDS)
- New cardiac dysfunction as defined by ECHO or direct measurement
of the cardiac index
- An arterial systolic blood pressure (SBP) of =90 mm Hg or a mean
arterial pressure (MAP) =70 mm Hg for at least 1 hour despite
adequate fluid resuscitation, adequate intravascular volume status,
or the need for vasopressors to maintain SBP >=90 mm Hg or
MAP >=70 mm Hg.
using the criteria below:
For the patient that had sepsis preoperatively, continuation of
the preoperatively identified signs postoperatively would not be
reported as a new postoperative sepsis. Worsening of the preope-
ratively identified signs would be reported as a new postoperative
sepsis.
o Sepsis is the systemic response to infection.
Answer YES if both of the following criteria are met:
Clinical documentation of infection (such as wound with purulent
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