Sepsis

Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. The word that matters is dysfunction. The infection starts the problem, but the harm comes from the body's own response: widespread inflammation, leaking blood vessels, abnormal vasodilation, and cells that cannot use the oxygen they are given. That is why a patient can deteriorate quickly even when the original infection looks small. Septic shock is a subset of sepsis in which the circulatory, cellular and metabolic abnormalities are profound enough to substantially increase mortality. Under the Sepsis-3 clinical definition, septic shock is sepsis with both of the following: - persisting hypotension that requires vasopressors to maintain a mean arterial pressure (MAP) of 65 mmHg or higher; and - a serum lactate above 2 mmol/L despite adequate volume resuscitation. Both criteria are required for the Sepsis-3 clinical definition. A patient with suspected infection, hypotension and a raised lactate may be heading into septic shock before these criteria can be formally met. The definitions describe how groups of patients are classified. They are not gates that must be passed...