| 1991 ACCP/SCCM Conference definitions8 | Definitions as used in our audit |
| SIRS: the presence of two or more of the following criteria: | As in the 1991 ACCP/SCCM Conference with the exception that, as band cell count is not routinely recorded in Southampton General Hospital, this was not used as a criterion |
| Body temperature >38°C or <36°C | |
| Heart rate >90 beats per minute | |
| Tachypnoea manifested by respiratory rate >20 breaths per minute or hyperventilation as indicated by Paco2 <32 mm Hg (4.3 kPa) | |
| Alteration in white blood cell count, such as >12 000/mm3, <4000/mm3 or the presence of >10% immature neutrophils (“bands”) | |
| Sepsis: SIRS resulting from an active infectious process | As discussed later, Rivers et al9 used the presence of a “documented or presumed infectious cause” as the discriminator for sepsis in their EGDT study and we have done the same. |
| Severe sepsis: sepsis associated with one or more of: Organ dysfunction Hypoperfusion abnormalities (eg, lactic acidosis, oliguria, acute alterations of mental status) Sepsis-induced hypotension (systolic blood pressure <90 mm Hg or reduction by 40 mm Hg or more from the baseline in the absence of other causes for hypotension) | The criteria used were those recommended by Rivers et al9 for the patient to be managed with EGDT, that is: |
| Systolic blood pressure <90 mm Hg or deviation of >40 mm Hg from the baseline | |
| Mean arterial pressure <65 mm Hg | |
| Serum lactate >4 mmol/l | |
| Any signs of hypoperfusion or organ dysfunction (eg, oliguria, acute confusion) | |
| Septic shock: severe sepsis with sepsis-induced hypotension that persists despite adequate fluid resuscitation | Due to difficulty in acquiring and analysing these data retrospectively, we allocated patients with severe sepsis and those with septic shock to one group: “severe sepsis or septic shock” |
ACCP/SCCM, American College of Chest Physicians/Society of Critical Care Medicine; Paco2, arterial carbon dioxide tension; EGDT, early goal-directed therapy
ACCP/SCCM, American College of Chest Physicians/Society of Critical Care Medicine; Paco2, arterial carbon dioxide tension; EGDT, early goal-directed therapy