Sandbox tachy2: Difference between revisions

Revision as of 17:33, 5 March 2015

Sepsis = infection (documented or suspected) and some of the following:

General variables

Fever (>38.3°C)
Hypothermia (core temperature <36°C)
Heart rate >90/min–1 or more than two SD above the normal value for age
Tachypnea
Altered mental status
Significant edema or positive fluid balance (>20 mL/kg over 24 hr)
Hyperglycemia (plasma glucose >140mg/dL or 7.7 mmol/L) in the absence of diabetes

Inflammatory variables

Hemodynamic variables

Arterial hypotension (SBP <90mm Hg, MAP <70mm Hg, or an SBP decrease >40mm Hg in adults or less than two SD below normal for age)

Organ dysfunction variables

Arterial hypoxemia (Pao2/Fio2 <300)
Acute oliguria (urine output <0.5 mL/kg/hr for at least 2 hrs despite adequate fluid resuscitation)
Creatinine increase >0.5mg/dL or 44.2 μmol/L
Coagulation abnormalities (INR >1.5 or aPTT >60 s)
Ileus (absent bowel sounds)
Thrombocytopenia (platelet count <100,000 μL–1)
Hyperbilirubinemia (plasma total bilirubin >4mg/dL or 70 μmol/L)

Tissue perfusion variables

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 * Hyperglycemia (plasma glucose &gt;140mg/dL or 7.7 mmol/L) in the absence of diabetes
 |-
 | style="font-size: 85%; background: #F5F5F5; padding: 5px 10px;" | Inflammatory variables
 * Leukocytosis (WBC count &gt;12,000 μL–1)
 * Leukopenia (WBC count &lt;4000 μL–1)
 * Normal WBC count with greater than 10% immature forms
 * Plasma C-reactive protein more than two SD above the normal value
 * Plasma procalcitonin more than two SD above the normal value
 |-
 | style="font-size: 85%; background: #DCDCDC; padding: 5px 10px;" | Hemodynamic variables
 * Arterial hypotension (SBP &lt;90mm Hg, MAP &lt;70mm Hg, or an SBP decrease &gt;40mm Hg in adults or less than two SD below normal for age)
 |-
 | style="font-size: 85%; background: #F5F5F5; padding: 5px 10px;" | Organ dysfunction variables
 * Arterial hypoxemia (Pao2/Fio2 &lt;300)
 * Acute oliguria (urine output &lt;0.5 mL/kg/hr for at least 2 hrs despite adequate fluid resuscitation)
 * Creatinine increase &gt;0.5mg/dL or 44.2 μmol/L
 * Coagulation abnormalities (INR &gt;1.5 or aPTT &gt;60 s)
 * Ileus (absent bowel sounds)
 * Thrombocytopenia (platelet count &lt;100,000 μL–1)
 * Hyperbilirubinemia (plasma total bilirubin &gt;4mg/dL or 70 μmol/L)
 |-
 | style="font-size: 85%; background: #DCDCDC; padding: 5px 10px;" | Tissue perfusion variables
 * Hyperlactatemia (&gt;1 mmol/L)
 * Decreased capillary refill or mottling
 |}