Definition
In humans, septic shock has a specific definition requiring several conditions to be met for diagnosis:
- First, SIRS (systemic inflammatory response syndrome) must be diagnosed by finding at least any two of the following:
- Tachypnea (high respiratory rate) > 20 breaths per minute, or on blood gas, a PCO2 less than 32 mmHg signifying hyperventilation.
- White blood cell count either significantly low, < 4000 cells/mm³ or elevated > 12000 cells/mm³.
- Heart rate > 90 beats per minute
- Temperature: Fever > 38.5 °C (101.3 °F) or hypothermia < 35.0 °C (95.0 °F)
- Second, there must be sepsis and not an alternative form cause of SIRS. Sepsis requires evidence of infection, which may include positive blood culture, signs of pneumonia on chest x-ray, or other radiologic or laboratory evidence of infection.
- Third, signs of end-organ dysfunction are required such as renal failure, liver dysfunction, changes in mental status, or elevated serum lactate.
- Finally, septic shock is diagnosed if there is refractory hypotension (low blood pressure that does not respond to treatment). This signifies that intravenous fluid administration alone is insufficient to maintain a patient's blood pressure from becoming hypotensive.
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