6 - Sepsis and Septic Shock 2026

Temp ≥ 38°C or ≤ 36°C;

HR ≥ 90 beats/min;

RR ≥ 20/min or PaCO2 ≤ 32mmHg or mechanical ventilation;

WBC ≥ 12,000/μL or ≤ 4,000/μL or ≥ 10% bands

What are the 4 components of the SIRS criteria?

Temp ≥ 38º C or ≤ 36º C

What is the criteria for SIRS based on temperature?

HR ≥ 90 beats/min

What is the criteria for SIRS based on heart rate?

RR ≥ 20/min or PaCO2 ≤ 32 mmHg or mechanical ventilation

Take note of the difference in cut-off for qSOFA which is RR ≥ 22/min

What is the criteria for SIRS based on respiration?

WBC ≥ 12,000/uL or ≤ 4,000/uL or ≥10% bands

What is the criteria for SIRS based on white blood cell (WBC) count?

RR ≥ 22/min

Altered mental status or GCS < 15

SBP ≤ 100 mmHg

What are the 3 criteria for qSOFA?

> 2 mmol/L

Septic shock is defined by an increase in lactate concentration > __ mmol/L in the absence of hypovolemia

MAP ≥ 65 mmHg

What is the target MAP for patients in septic shock?

Vasopressors

DOC: Norepinephrine

Septic shock can be identified by the need for ___ to maintain MAP ≥ 65 mmHg despite adequate fluid resuscitation

30 mL/kg

The initial fluid resuscitation in septic shock involves the infusion of ___ mL/kg IV crystalloids in the first 3 hours

Hgb < 7 g/dL

Blood transfusion in septic shock is indicated when Hgb < __ g/dL

< 10,000/mm3

Platelet transfusion is indicated in septic shock when platelet count is ___ even without bleeding

< 20,000/mm3

Platelet transfusion is indicated in septic shock when platelet count is ___ in patients at high risk for bleeding

< 50,000/mm3

Platelet transfusion is indicated in septic shock when platelet count is ___ in active bleeding

Blood glucose < 180 mg/dL

What is the target glucose level in the management of septic shock?