Clinical meaning
Sepsis-3 (2016) defined sepsis as 'life-threatening organ dysfunction caused by a dysregulated host response to infection,' replacing SIRS-based criteria. Key tools: (1) SOFA Score assesses 6 systems — respiratory (PaO2/FiO2), coagulation (platelets), liver (bilirubin), cardiovascular (MAP/vasopressors), CNS (GCS), renal (creatinine/UO). Acute increase ≥2 from baseline = sepsis. (2) qSOFA: bedside screening (RR ≥22, altered mentation, SBP ≤100); score ≥2 identifies high-risk patients but does NOT diagnose sepsis. (3) Septic Shock: sepsis + vasopressors for MAP ≥65 AND lactate >2 despite adequate resuscitation. SIRS criteria (temperature, HR, RR, WBC) are no longer used for sepsis diagnosis due to poor specificity. Sepsis is a CLINICAL diagnosis — no single test confirms it.
Diagnosis & workup
Diagnostics & workup: - SOFA score calculation across 6 organ systems - qSOFA bedside screen: RR ≥22, altered mental status, SBP ≤100 - Blood cultures ≥2 sets before antibiotics - Serum lactate (>2 = hypoperfusion; >4 = severe) - Procalcitonin for bacterial vs. non-bacterial differentiation - Source-specific cultures and imaging - CBC, BMP, LFTs, coagulation panel