Sepsis Has a New Definition

Sepsis, septic shock redefined by international consensus

(RxWiki News) Despite being a major public health concern, the definition of sepsis has not been reevaluated in nearly 15 years — until now that is.

A new report detailed the updated definitions and clinical criteria for both sepsis and septic shock. Experts said these new definitions could help doctors more effectively recognize and manage the potentially deadly conditions.

According to the Centers for Disease Control and Prevention (CDC), sepsis kills more than 258,000 Americans each year. Between 28 and 50 percent of the people who develop it do not survive.

Sepsis is a life-threatening complication of infection. It occurs when the chemicals released into the bloodstream to fight an infection trigger inflammatory responses within the body. This can damage multiple organ systems, causing them to fail. If sepsis progresses to septic shock, blood pressure can drop dramatically and lead to death.

According to the report, sepsis cost the US more than $20 billion in hospital expenses in 2011. Although actual incidence cannot be confirmed, research indicates that sepsis may be the leading cause of death and critical illness worldwide. There is also evidence that sepsis survivors can have long-term physical, psychological and cognitive disabilities that require medical care.

Despite more than a decade’s worth of research into the functions, management and incidence of sepsis and septic shock, the definitions have remained the same since 2001.

In 2014, the Society of Critical Care Medicine and the European Society of Intensive Care Medicine formed a task force to reevaluate these definitions.

The council eventually redefined sepsis as "a life-threatening condition that arises when the body’s response to an infection injures its own tissues and organs."

Septic shock was defined as "a subset of sepsis in which circulatory, cellular, and metabolic abnormalities present a greater risk for death than sepsis alone."

When treating suspected infection in adults, the council recommends physicians identify the patients most likely to have sepsis. This would include patients with a respiratory rate of 22/min or greater, an altered mental state and/or a systolic blood pressure of 100 mmHg or less.

According to the CDC, sepsis can be caused by any infection (even a minor one) and can affect any part of the body. This can include skin, lung, urinary tract and abdominal infections.

Patients with weakened immune systems — especially babies, the elderly, those with chronic illnesses, and those with severe burns or wounds — are more likely to develop sepsis.

Sepsis symptoms can include fever, pain, pale skin, extreme sleepiness, confusion and shortness of breath.

If you suspect that you or someone you know has sepsis, call 911 immediately. If caught early, sepsis can be effectively treated with antibiotics and intravenous fluids.

This report was published Feb. 23 in the journal JAMA. It was presented simultaneously at the Society of Critical Care Medicine's 45th Critical Care Congress.

The Society of Critical Care Medicine and the European Society of Intensive Care Medicine funded this research.

The authors report several potential conflicts of interest, including ties to the pharmaceutical companies InflaRx, Bayer, Biotest and Merck.

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Review Date: 
February 23, 2016