Sepsis

  • Sepsis treatment should be targeted at the specific source whenever possible

  • Refer to appropraite syndrome to find emperic treatment recommendations for specific sources of infection.

Severe Sepsis

If the patient meets all 3 of the criteria listed below, the patient has severe sepsis:

1. Suspected infection

2. ≥ 2 SIRS Criteria:

  • Temperature ≥ 38.3°C or < 36°C
  • Heart rate > 90 bpm
  • Respiratory rate > 20 or mechanical ventilation
  • WBC > 12,000 or < 4,000 mm3

3. Exhibit one acute organ dysfunction

  • Systolic BP < 90 mmHg

or MAP < 65 mmHg after 30 ml/kg fluid bolus
- Serum lactate ≥ 2 mmol/L
- Coagulopathy
- Creatinine level > 2 mg/dl or elevation > 0.5 mg/dl above baseline
- Urine output < 0.5 ml/kg/hr for 2 hours
- PLT count < 100,000
- Bilirubin > 2 mg/dl (34.2 mmol/L)
- Acute respiratory failure