From the Guidelines
The criteria for Systemic Blood Pressure (SBP) in sepsis is a mean arterial pressure of at least 65 mm Hg, and the White Blood Cell (WBC) count is not explicitly defined as a criterion for sepsis diagnosis in the provided guidelines. The diagnosis and management of sepsis involve a combination of clinical assessment, laboratory tests, and imaging studies. According to the Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016 1, the initial resuscitation goals include achieving a mean arterial pressure of at least 65 mm Hg. In terms of WBC count, the guidelines do not specify a particular threshold for diagnosing sepsis. However, they do recommend obtaining appropriate routine microbiologic cultures, including blood cultures, before starting antimicrobial therapy in patients with suspected sepsis or septic shock 1. The guidelines also emphasize the importance of early recognition and treatment of sepsis, with administration of IV antimicrobials as soon as possible after recognition and within one hour for both sepsis and septic shock 1. It is essential to note that the diagnosis of sepsis is based on a combination of clinical and laboratory findings, and the WBC count is just one of the many factors that are considered. The guidelines from 2012 1 also support the idea that early quantitative resuscitation and administration of broad-spectrum antimicrobials are crucial in the management of sepsis. However, the most recent guidelines from 2016 1 provide the most up-to-date recommendations for the diagnosis and management of sepsis. Key points to consider in the diagnosis and management of sepsis include:
- Achieving a mean arterial pressure of at least 65 mm Hg
- Obtaining appropriate routine microbiologic cultures
- Administering IV antimicrobials as soon as possible after recognition and within one hour for both sepsis and septic shock
- Considering the use of crystalloids and albumin in fluid resuscitation
- Avoiding the use of hetastarch formulations
- Using norepinephrine as the first-choice vasopressor to maintain mean arterial pressure.
From the Research
Systemic Blood Pressure (SBP) and White Blood Cell (WBC) count in Sepsis
- The provided studies do not directly address the criteria for Systemic Blood Pressure (SBP) and White Blood Cell (WBC) count in Sepsis.
- However, the studies discuss Spontaneous Bacterial Peritonitis (SBP), which is a complication of ascites, especially in cirrhosis, and provide information on the diagnosis and treatment of SBP.
- According to the studies, the diagnosis of SBP is set in neutrophilic leukocytes in ascites ≥ 250 cells/mm³ 2, 3, 4, 5.
- The studies also discuss the importance of early diagnosis and treatment of SBP, as well as the use of scoring systems to predict the risk of SBP 5.
- Additionally, the studies highlight the importance of guideline-recommended treatments, such as intravenous albumin, in reducing mortality and improving outcomes in patients with SBP 6.
- The criteria for Systemic Blood Pressure (SBP) and White Blood Cell (WBC) count in Sepsis are not explicitly stated in the provided studies, and therefore, cannot be determined based on the available evidence.
Diagnosis of Spontaneous Bacterial Peritonitis (SBP)
- The diagnosis of SBP is based on the presence of neutrophilic leukocytes in ascites ≥ 250 cells/mm³ 2, 3, 4, 5.
- The diagnosis can also be supported by positive bacterial cultures, although this is not always necessary 2, 3, 4.
- Other factors, such as the presence of thrombocytopenia, age, and elevated C-reactive protein (CRP) levels, can also be used to predict the risk of SBP 5.