Definitions (as per Society of Critical Care Medicine & the European Society of Intensive Care Medicine)

 

  • Sepsis: Organ dysfunction caused by a dysregulated host response to infection.  Organ dysfunction is ≥2 points on the SOFA score (see below)  

  • Septic Shock: Patients with sepsis who despite adequate fluid resuscitation, require vasopressors to maintain a mean arterial pressure (MAP) ≥65 mmHg and have a lactate >2 mmol/L 

 

 

SOFA (Sequential Organ Failure Assessment) Score 

 

  • Pulmonary: PaO2/FiO2

    •  >400 (0 points)

    • 301 to 400 (1 point)

    • ≤300 (2 points)

    • 101 to 200 with ventilatory support (3 points)

    • ≤100 with ventilatory support (4 points)

  • Coagulation: Platelets (/mm3)

    • >150K (0 points) 

    • 101-150K (1 point)

    • 51-100K (2 points)

    • 21-50K (3 points)

    • ≤20K (4 points)

  • Liver: Bilirubin (mcmol/L)

    • 20 (0 points)

    • 20-32 (1 point)

    • 33-101 (2 points)

    • 102-204  (3 points)

    • >204  (4 points)

  • Cardiovascular: Blood Pressure 

    • Hypotension absent (0 points)

    • Mean arterial pressure <70 mmHg (1 point)

    • On dopamine ≤5 mcg/kg/min or any dobutamine (2 points)

    • On dopamine >5 mcg/kg/min, epinephrine ≤0.1 mcg/kg/min or norepinephrine ≤0.1 mcg/kg/min (3 points)

    • On dopamine >15 mcg/kg/min or epinephrine >0.1 mcg/kg/min or norepinephrine >0.1 mcg/kg/min (4 points)

  • Brain: GCS Score 

    • 15 (0 points)

    • 13-14 (1 point)

    • 10-12 (2 points)

    • 6-9 (3 points)

    • <6 (4 points)

  • Kidney: Renal Function

    • Creatinine 110 mcmol/L (0 points)

    • Creatinine 110-170 mcmol/L (1 point)

    • Creatinine 171-299 mcmol/L (2 points)

    • Creatinine 300-440 mcmol/L or urine output 200-500 cc/day (3 points)

    • Creatinine >440 mcmol/L or urine output <200 cc/day (4 points)