Sepsis is a syndrome, with a poorly understood pathogenesis, characterized clinically by a recognized set of signs and symptoms in someone with presumed infection.
Terminology
Sepsis was defined by The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) in 2016 as "life-threatening organ dysfunction caused by a dysregulated host response to infection" 1.
Septic shock forms a subpopulation of the sepsis cohort, manifesting as synchronous severe cardiovascular, cellular and metabolic dysfunctions, linked to an elevated risk of mortality, versus sepsis alone 1.
Establishing the diagnosis of septic shock in adult patients requires that despite satisfactory fluid resuscitation there is:
- hypotension, necessitating pressors to achieve an average systolic blood pressure of ≥65 mmHg
and
- serum lactate >2 mmol/L
NB The separate condition "severe sepsis" has now been abandoned. "Septicemia" is generally not felt to be helpful any longer due to it being too narrow in scope.