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SIRS, Sepsis, and Septic Shock Criteria

Classic ACCP/SCCM systemic inflammation and sepsis staging.

SIRS, Sepsis, and Septic Shock Criteria
Temperature >38 C or <36 C
Heart rate >90 /min
Respiratory rate >20 /min or PaCO2 <32 mmHg
WBC >12 or <4 x10^9/L, or >10% bands
Suspected or confirmed source of infection
Sepsis-related organ dysfunction or hypoperfusion (e.g. lactic acidosis, oliguria, altered mentation)
Hypotension persisting despite adequate fluid resuscitation
ResultCriteria not met

Fewer than 2 SIRS criteria.

SIRS criteria met
0 of 4

When to use

  • Staging systemic inflammation, sepsis, and septic shock at the bedside using the 1991/2001 consensus definitions.

Formula

SIRS = >=2 of: temperature >38 or <36 C, HR >90, RR >20 (or PaCO2 <32), WBC >12 or <4 or >10% bands. Sepsis = SIRS + infection. Severe sepsis = sepsis + organ dysfunction. Septic shock = sepsis + fluid-refractory hypotension.

Pearls and pitfalls

  • These are the classic ACCP/SCCM (Sepsis-1/2) criteria; Sepsis-3 (2016) redefines sepsis using SOFA and qSOFA.

References

  1. Bone RC, et al. Chest. 1992;101(6):1644-55.