Sepsis: 15 years later #Sepsis3

The European Society of Intensive Care Medicine and the Society of Critical Care Medicine recently teamed up in a critical care task force to redefine sepsis as numerous medical advances have been made since the 2001 revisions.

The major take home points from the new definition include the following:

  • Definitions:
    • Sepsis: Life-threatening organ dysfunction caused by a dysregulated host response to infection
    • Septic shock: Sepsis with circulatory and cellular/metabolic abnormalities profound enough to substantially increase mortality
  • Clinical Criteria:
    • Sepsis: Suspected or documented infection and an acute increase of ≥ 2 SOFA points
    • Septic Shock: Sepsis and vasopressor therapy needed to elevate MAP ≥ 65 mmg Hg and lactate > 2 mmol/L (18 mg/dL) after adequate fluid resuscitation

What is SOFA??? It sands for Sepsis-related Organ Failure Assessment and it serves as a proxy for organ dysfunction. The qSOFA score (aka quickSOFA) is a bedside tool that may identify patients at higher risk of poor outcomes outside of the ICU.  The 3 parameters assessed by the tool include respiratory rate (high defined as ≥22 breaths/min), low blood pressure defined as SBP≤100 mmHg, and altered mental status defined as a GSC <15 and the tool assigns one point for each measure. The tool may help identify patients that should trigger a lower threshold to be moved to the ICU setting.

If you’d like to learn more (and you probably should), please visit the links below for more comprehensive information behind the revisions and scoring tools!

The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)

JAMA Sepsis

qSOFA score