Sepsis and Septic Shock, New Definition!

Infectious Disease PGY1 PGY2 PGY3 PGY4 Sepsis

JAMA Published The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) by Physicians from USA, Germany, France, Australia, Canada, Netherlands, and Belgium. The reason for this new definition is the limitation of sensitivity and specificity of SIRS criteria, too much focus on inflammation cascade, and too many terms that really does not make sense such as sepsis, septic shock, sever sepsis.

What is the new definition?

  1. Sepsis should be defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. 
  2. Sequential Organ Failure Assessment (SOFA) (originally the Sepsis-related Organ Failure Assessment) >=2. A four system Score:
    1. pa02/Fio2
    2. Platelet
    3. Bilirubin
    4. MAP
    5. GCS
    6. Cre
      A SOFA score ≥2 reflects an overall mortality risk of approximately 10%
  3. Septic shock can be identified with a clinical construct of sepsis with persisting hypotension requiring vasopressors to maintain MAP ≥65 mm Hg and having a serum lactate level >2 mmol/L (18 mg/dL) despite adequate volume resuscitation.
    This combination is associated with hospital mortality rates greater than 40%. 
  4. qSOFA (Quick SOFA) Criteria
    1. Respiratory rate ≥22/min
    2. Altered mentation
    3. Systolic blood pressure ≤100 mm Hg


Link to ICD Code


Full Article


There will be a lot of criticism and also rejection to accept these new terms, Here you are!

Chest: New Sepsis Criteria: A Change We Should Not Make