Systemic Inflammatory Response Syndrome (SIRS)
• Non-specific (infections vs non-infectious)
• ≥2 of the following:
o Temp >38°C or <36°C
o HR >90 bpm
o RR >20 or PaCO₂ <32 mmHg
o WBC >12,000/mm³, <4,000/mm³, or >10% bands
Sepsis
• Organ dysfunction due to dysregulated host response to infection.
• SOFA score increases by ≥2.
• qSOFA (≥2 indicates high risk):
o Altered mental status (GCS <15)
o RR ≥22/min
o SBP ≤100 mmHg
Severe Sepsis (Obsolete Term in Sepsis-3, 2016)
• Sepsis + tissue hypoperfusion/organ dysfunction.
Septic Shock
• Sepsis + circulatory failure
o Hypotension requiring vasopressors (MAP <65 mmHg).
o Lactate >2 mmol/L
Management (Surviving Sepsis Campaign Guidelines)
• Early recognition & treatment (within 1 hour)
• IV fluids (30 mL/kg crystalloid in 1st 3 hours)
• Broad-spectrum antibiotics ASAP
• Vasopressors (norepinephrine) if MAP <65 mmHg
• Source control (drain abscesses, remove infected devices)
• Supportive care (oxygenation, ventilation, glycemic control, DVT/stress ulcer prophylaxis)
