{"id":751,"date":"2016-02-28T20:30:45","date_gmt":"2016-02-29T01:30:45","guid":{"rendered":"http:\/\/emeddoc.org\/?p=751"},"modified":"2016-02-29T22:25:13","modified_gmt":"2016-03-01T03:25:13","slug":"sepsis-and-septic-shock-new-definition","status":"publish","type":"post","link":"https:\/\/emeddoc.org\/?p=751","title":{"rendered":"Sepsis and Septic Shock, New Definition!"},"content":{"rendered":"<p>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.<\/p>\n<p>What is the new definition?<\/p>\n<ol>\n<li><span class=\"Abstract 0\"><span class=\"Abstract 0\"><strong><span style=\"color: #ff0000;\">Sepsis<\/span><\/strong> should be defined as life-threatening <strong>organ dysfunction<\/strong> caused by a dysregulated host response to infection.<\/span><\/span>&nbsp;<\/li>\n<li><span id=\"scm6MainContent_ucArticleContent_rptSections_lblSection_27\" class=\"Paragraph 117182100\">Sequential Organ Failure Assessment (<span style=\"color: #ff0000;\">SOFA<\/span>) (originally the Sepsis-related Organ Failure Assessment<\/span>) &gt;=2. <span id=\"scm6MainContent_ucArticleContent_rptSections_lblSection_0\" class=\"Abstract 0\">A four system Score:<\/span>\n<ol>\n<li>pa02\/Fio2<\/li>\n<li>Platelet<\/li>\n<li>Bilirubin<\/li>\n<li>MAP<\/li>\n<li>GCS<\/li>\n<li>Cre<br \/>\nA SOFA score \u22652 reflects an overall mortality risk of approximately 10%<\/li>\n<\/ol>\n<\/li>\n<li><span style=\"color: #ff0000;\"><strong>Septic shock<\/strong><\/span> can be identified with a clinical construct of <strong>sepsis<\/strong> with persisting <strong>hypotension<\/strong> requiring <strong>vasopressors<\/strong> to maintain MAP \u226565 mm Hg and having a <strong>serum lactate<\/strong> level &gt;2 mmol\/L (18 mg\/dL) despite adequate volume resuscitation.<br \/>\n<span class=\"Abstract 0\"><span class=\"Abstract 0\">This combination is associated with hospital mortality rates greater than 40%.<\/span><\/span>&nbsp;<\/li>\n<li><span style=\"color: #ff0000;\"><strong>qSOFA<\/strong><\/span> (Quick SOFA) Criteria\n<ol>\n<li>Respiratory rate \u226522\/min<\/li>\n<li>Altered mentation<\/li>\n<li>Systolic blood pressure \u2264100 mm Hg<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p><a href=\"http:\/\/jama.jamanetwork.com\/article.aspx?articleid=2492881#jsc160002t2\">Link to ICD Code<\/a><\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"http:\/\/jama.jamanetwork.com\/article.aspx?articleid=2492881\">Full Article<\/a><\/p>\n<p>&nbsp;<\/p>\n<p>There will be a lot of criticism and also rejection to accept these new terms, Here you are!<\/p>\n<p><a href=\"http:\/\/www.sciencedirect.com\/science\/article\/pii\/S0012369216415230\">Chest: New Sepsis Criteria: A Change We Should Not Make<\/a><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>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 [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[20,13,14,15,16,11],"tags":[],"class_list":["post-751","post","type-post","status-publish","format-standard","hentry","category-infectious-disease","category-pgy1","category-pgy2","category-pgy3","category-pgy4","category-sepsis"],"_links":{"self":[{"href":"https:\/\/emeddoc.org\/index.php?rest_route=\/wp\/v2\/posts\/751","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/emeddoc.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/emeddoc.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/emeddoc.org\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/emeddoc.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=751"}],"version-history":[{"count":5,"href":"https:\/\/emeddoc.org\/index.php?rest_route=\/wp\/v2\/posts\/751\/revisions"}],"predecessor-version":[{"id":762,"href":"https:\/\/emeddoc.org\/index.php?rest_route=\/wp\/v2\/posts\/751\/revisions\/762"}],"wp:attachment":[{"href":"https:\/\/emeddoc.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=751"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/emeddoc.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=751"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/emeddoc.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=751"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}