What is the definition of sepsis and its diagnostic criteria?

From the Guidelines

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, and the criteria for diagnosing sepsis include suspected or documented infection plus an acute increase in Sequential Organ Failure Assessment (SOFA) score of 2 or more points, as established by the Sepsis-3 consensus in 2016 1. The definition of sepsis has evolved over time, and the current understanding is based on the Sepsis-3 consensus, which emphasizes the importance of organ dysfunction in the diagnosis of sepsis. The SOFA score is a widely used tool to assess organ dysfunction, and an increase of 2 or more points is considered indicative of sepsis.

Key Criteria for Diagnosing Sepsis

• Suspected or documented infection
• Acute increase in SOFA score of 2 or more points
• Quick SOFA (qSOFA) criteria can be used for quick identification outside the ICU, which includes:
  • Altered mental status
  • Systolic blood pressure ≤100 mmHg
  • Respiratory rate ≥22 breaths per minute
  • Two or more of these qSOFA criteria suggest possible sepsis

Septic Shock

Septic shock is defined as sepsis with persistent hypotension requiring vasopressors to maintain mean arterial pressure ≥65 mmHg and having a serum lactate level >2 mmol/L despite adequate fluid resuscitation, as stated in the Sepsis-3 consensus 1. Early recognition and prompt treatment of sepsis and septic shock are crucial to improve survival rates, and the use of broad-spectrum antibiotics, fluid resuscitation, and vasopressors if needed is recommended 1. The pathophysiology of sepsis involves an overwhelming inflammatory response triggered by pathogens, leading to endothelial dysfunction, microcirculatory abnormalities, and ultimately organ dysfunction. It is essential to note that the management of sepsis requires a comprehensive approach, including fluid resuscitation, antimicrobial therapy, and supportive care, and that the use of guidelines and protocols can help improve outcomes in patients with sepsis 1.

From the Research

Definition of Sepsis

• Sepsis is defined as a life-threatening organ dysfunction due to a dysregulated response of the body to an infection 2, 3.
• It represents an important infectious process with systemic manifestation, and its incidence is continuously increasing 4.

Criteria for Sepsis

• The criteria for sepsis are based on the assumption that sepsis is primarily caused by the inflammatory reaction of the body to an infection 2.
• Septic shock occurs when a condition of persisting hypotension with the continuous need for vasopressor agents and serum lactate levels of >2 mmol/l despite administration of sufficient volume and fluid is present 2.
• The diagnosis of sepsis is discussed in the context of the consequences for the diagnosis of sepsis, and the current controversies on the most important aspects of the therapy of sepsis 2.

Key Characteristics of Sepsis

• Sepsis is a heterogeneous syndrome characterized by severe organ dysfunction caused by a dysregulated host response to infection 3.
• The pathogenesis of sepsis involves a systemic inflammatory response, which may cause tissue damage leading to organ failure 4.
• The knowledge obtained from experimental studies could not be utilized due to the short therapeutic window of new immunotherapies 4.