Table 1

Definitions

Systemic inflammatory response syndrome (SIRS)
SIRS is present if there are at least 2 of:
  •  ▸ Temperature >38.3°C or <36.0°C

  •  ▸ Pulse >90/min

  •  ▸ RR >20/min

  •  ▸ New confusion/drowsiness

  •  ▸ White cell count >12 or <4×109/L

  •  ▸ Blood glucose >7.7 mmol/L (non-diabetic patients)

Severity of sepsis
SeverityDefinition
Uncomplicated sepsisSIRS+presumed or confirmed infection
Severe sepsisSepsis+one or more organ dysfunction criteria (other than shock):
  •  ▸ Bilateral lung infiltrates+new need for oxygen to maintain saturations >90% or bilateral lung infiltrates with PaO2/FiO2 ratio <300 mm Hg or 39.9 kPa

  •  ▸ Lactate >2.0 mmol/L

  •  ▸ Serum creatinine >176.8 μmol/L or urine output <0.5 mL/kg/h for two successive hours

  •  ▸ INR >1.5 or aPTT >60 s

  •  ▸ Platelet count <100×109/L

  •  ▸ Bilirubin >34.2 μmol/L

Septic shockSepsis+shock
  •  ▸ Lactate >4 mmol/L at any time point

  •  ▸ Hypotension persisting after 30 mL/kg intravenous fluid, defined as:

    •  – Systolic BP <90 mm Hg

    •  – Mean arterial pressure <65 mm Hg or a fall of >40 mm Hg from the patient's usual systolic BP

National early warning score (NEWS)
Physiological parameters3210123
RR≤89–1112–2021–24≥25
Oxygen saturation≤9192–9394–95≥96
Any supplemental oxygenYesNo
Temperature≤35.035.1–36.036.1–38.038.1–39.0≥39.1
Systolic BP≤9091–100101–110111–219≥220
HR≤4041–5051–9091–10111–30≥131
Level of consciousnessAV, P, U
  • Adapted from the 2012 Surviving Sepsis Campaign guidelines and the 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference.5 ,19 NEWS adapted according to Royal College of Physicians.17 AVPU; A= alert, V= responsive to voice, P= responsive to pain, U= unresponsive. INR; international normalised ratio. aPTT; activated partial thromboplastin time.