May 6, 2016
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Sepsis (cont.)

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What is sepsis?

The newest definition of sepsis has recently been published. In 2016, the Third International Consensus Definitions Task Force defined sepsis as "life-threatening organ dysfunction due to a dysregulated host response to infection." The new criteria are based on just three symptoms:

  • Altered mental status
  • Fast respiratory rate (> 22 breaths/minute)
  • Low blood pressure (≤ 100 mm Hg systolic)

Patients who meet the above criteria likely have sepsis and are also termed septic. Blood tests are no longer required for the diagnosis. Essentially, patients who show two of the three criteria listed above are considered likely to be septic according to studies that led to the new criteria. The term QSOFA (quick sequential organ failure assessment) represents a scoring system that gives one point to each of the three symptoms listed above; if the patient score is two or greater, the patient is likely to have sepsis according to the Third International Consensus Definitions Task Force. Because sepsis is so serious a problem for the patient that usually requires emergency treatment, the goal of the task force was to simplify the criteria used to determine the likelihood of sepsis in an individual patient quickly.

These criteria may continue to be modified by other medical groups. For example, pediatric groups use somewhat different criteria for children. Other groups want to add other criteria. As stated by the 2016 group that produced the newest definitions, they consider definitions still as "a work in progress."

Terms that are often used in place of sepsis are bacteremia, septicemia, and blood poisoning. However, bacteremia means the presence of bacteria in the blood; this can occur without any of the criteria listed above and should not be confused with sepsis. For example, you can brush your teeth and get bacteremia for a short time and have no SIRS criteria occur. Unfortunately, septicemia has had multiple definitions over time; it has been defined as bacteremia, blood poisoning, bacteremia leading to sepsis, sepsis, and other variations. Although septicemia appears frequently in the medical literature, a reader must be sure which definition the author is using. Some experts suggest the terms blood poisoning and septicemia not be used since they are poorly defined, but it is difficult for the medical community to disregard such terms that have been used for many decades.

Some medical researchers consider sepsis to have three stages. The first stage is the least severe and usually has symptoms of fever and an increased heart rate. The second stage is more severe and is characterized by symptoms of difficulty breathing and possible organ malfunctions, while the third is the most severe stage (septic shock) with life-threatening low blood pressure. Not all researchers agree with these stages; some researchers choose not to consider sepsis in stages.

Medically Reviewed by a Doctor on 4/4/2016

Source: MedicineNet.com
http://www.medicinenet.com/sepsis/article.htm

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