Severe Sepsis and Septic Shock-Recent Concepts

Acute lung injury or acute respiratory distress syndrome. Cardiac dysfunction, as defined by echocardiography. Septic shock : Septic shock exists if there is severe sepsis plus one or both of the following Systemic mean blood pressure is <60 mmHg (or <80 mmHg if the patient has baseline hypertension for at least 1 h despite adequate fluid resuscitation. (adequate fluid resuscitation is defined as infusion of 20 to 30 mL/kg of starch, infusion of 40 to 60 mL/ kg of saline solution, or a measured pulmonary capillary wedge pressure (PCWP) of 12 to 20 mmHg) or maintaining the systemic mean blood pressure >60 mmHg (or >80 mmHg if the patient has baseline hypertension) requires dopamine >5 mcg/kg per min, nor epinephrine <0.25 mcg/kg per min, or epinephrine <0.25 mcg/kg per min despite adequate fluid resuscitation.