American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis.

OBJECTIVE: To define the terms "sepsis" and "organ failure" in a precise manner.

DATA SOURCES: Review of the medical literature and the use of expert testimony at a consensus conference.

SETTING: American College of Chest Physicians (ACCP) headquarters in Northbrook, IL.

PARTICIPANTS: Leadership members of ACCP/Society of Critical Care Medicine (SCCM).

RESULTS: An ACCP/SCCM Consensus Conference was held in August of 1991 with the goal of agreeing on a set of definitions that could be applied to patients with sepsis and its sequelae. New definitions were offered for some terms, while others were discarded. Broad definitions of sepsis and the systemic inflammatory response syndrome were proposed, along with detailed physiologic variables by which a patient could be categorized. Definitions for severe sepsis, septic shock, hypotension, and multiple organ dysfunction syndrome were also offered. The use of severity scoring methods were recommended when dealing with septic patients as an adjunctive tool to assess mortality. Appropriate methods and applications for the use and testing of new therapies were recommended.

CONCLUSION: The use of these terms and techniques should assist clinicians and researchers who deal with sepsis and its sequelae.