Changing Definitions of Sepsis
- 10 July 2017
- journal article
- review article
- Published by Galenos Yayinevi in Turkish Journal of Anesthesia and Reanimation
- Vol. 45 (3), 129-138
- https://doi.org/10.5152/tjar.2017.93753
Abstract
Sepsis is one of the main causes of morbidity and mortality in critically ill patients despite the use of modern antibiotics and resuscitation therapies. Outcomes in sepsis have improved overall, probably because of an enhanced focus on early diagnosis and other improvements in supportive care, but mortality rates still remain unacceptably high. The diagnosis and definition of sepsis is a critical problem due to the heterogeneity of this disease process. Although it is apparent that much more needs to be done to advance our understanding, sepsis and related terms remain difficult to define. A 1991 consensus conference developed initial definitions that systemic inflammatory response syndrome (SIRS) to infection would be called sepsis. Definitions of sepsis and septic shock were revised in 2001 to incorporate the threshold values for organ damage. In early 2016, the new definitions of sepsis and septic shock have changed dramatically. Sepsis is now defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. The consensus document describes organ dysfunction as an acute increase in total Sequential Organ Failure Assessment (SOFA) score two points consequently to the infection. A significant change in the new definitions is the elimination of any mention of SIRS. The Sepsis-3 Task Force also introduced a new bedside index, called the qSOFA, to identify outside of critical care units patients with suspected infection who are likely to develop sepsis. Recently updated the consensus definitions improved specificity compared with the previous descriptions.Keywords
This publication has 40 references indexed in Scilit:
- The new sepsis consensus definitions: the good, the bad and the uglyIntensive Care Medicine, 2016
- A Framework for the Development and Interpretation of Different Sepsis Definitions and Clinical CriteriaCritical Care Medicine, 2016
- Sepsis: older and newer conceptsThe Lancet Respiratory Medicine, 2016
- Revising definitions of sepsisNature Reviews Nephrology, 2015
- Systemic Inflammatory Response Syndrome Criteria in Defining Severe SepsisNew England Journal of Medicine, 2015
- Molecular biology of inflammation and sepsis: A primer*Critical Care Medicine, 2009
- Evaluation of end-tidal carbon dioxide role in predicting elevated SOFA scores and lactic acidosisInternal and Emergency Medicine, 2008
- Historical perspective of the word “sepsis”Intensive Care Medicine, 2006
- Early Coagulopathy Predicts Mortality in TraumaJournal Of Trauma-Injury Infection and Critical Care, 2003
- 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions ConferenceCritical Care Medicine, 2003