Following identification of a patient with sepsis, the clinician must assess the patient for the presence of acute organ dysfunction (severe sepsis). The presence of acute organ dysfunction is often recognized clinically by the patient’s presenting signs and symptoms. However, in some instances laboratory data or results of invasive monitoring will confirm the diagnosis of organ dysfunction.

The illustration of the patient on this slide has arrows pointing to various organs that might provide clues to the presence of organ dysfunction. Indications of organ dysfunction include:

Central nervous system: altered consciousness, confusion, psychosis, delirium

Respiratory system: tachypnea, hypoxemia, oxygen saturation <90%, decreased ratio of arterial oxygen vs inspired oxygen

Liver: jaundice, increased liver enzymes, hypoalbuminemia, increased prothrombin time

Cardiovascular: tachycardia, hypotension, increased central venous pressure, increased pulmonary artery occlusive pressure

Kidney: oliguria, anuria, increased creatinine

Hematological: thrombocytopenia, abnormal coagulation tests, decreased levels of Protein C, increased D-dimers