Medicina

Definitions for sepsis and organ failure and
guidelines for the use of innovative therapies in
sepsis. The ACCP/SCCM Consensus Conference
Committee. American College of Chest
Physicians/Society of Critical Care Medicine.
R C Bone, R A Balk, F B Cerra, R P Dellinger, A M Fein, W A Knaus, R M Schein
and W J Sibbald
Chest 1992;101;1644-1655
DOI 10.1378/chest.101.6.1644

The online versionof this article, along with updated information and
services can be found online on the World Wide Web at:
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CHEST is the official journal of the American College of Chest Physicians. It
has been published monthly since 1935. Copyright 2007 by the American
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(http://www.chestjournal.org/misc/reprints.shtml) ISSN:0012-3692

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Copyright © 1992 American College of Chest Physicians

accplsccm consensus conference
Definitions
Guidelines
Sepsis
THE

ACCP/SCCMRogerC.

RobertA.

Balk,

M.D.,

B. Cerra,

Frank

M. D.

Alan

College

Medicine

ofChest

in August
1991 with the goal
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
brook

along
apatient

which
sepsis,

septic

function

with

were

held

College
Care

and

also

offered.

of Chest

Medicine

in Chicago

parameters

M. H. Schein,
M.D.
j Sibbald,
M.D. , F. C.C.P
methods

1991

of

Conference
with

the

MODS

= multiple
inflammatory

systemic

of

goal

of

be applied
It was the

Two
and
and

thegeneralized

other

“sepsis”
and includes
sepsis-associated
organ dysfunctions
as well.
We expect
that the broad
definitions
proposed
in this report
will improve
our ability
to
and

thus

allow
For

addition,

early

editorial

of the

disease

therapeutic
comment

possible,

page

In

ofresearch

protocols

will

be possible,
as will improveddissemination
and application ofinformation
derived
from clinical
studies.
We
hope that the continuing
research
on the inflammatory
response

to infection

cellular
sis and

and immunologic
related
organ

will

allow

us to understand

mechanisms
dysfunctions

death.
We recognize
the limitations
we have proposed
and urge further
these

clinical

Reprint
Center,requests:
Dr. Bone, Rush-Presbyterian
1753 West Congress Parkway, Chicago

1644

concepts,

critical

the

that cause sepand, sometimes,
of the
studies

phases,

definitions
to validate

and
St.

60612

measures

b.ske

Medical

issues

with

The

more

tools

are

sepsis;

risk

of evaluation.

also

addressed

in this

article

the discussionof the causes
(1) the utilization
of severity-

and

therapies

systemic
1.2

(2) guidelines

in severe

response

Sepsis

is an

morbidity
and
munocompromised,
sis has

1481

sophisticated

using

SIRS

for the

of

use

of

sepsis.

SEPSIS

sepsis.

intervention.
see

the standardization

was

scoring
systems
that allow
the consistentdescription,
and risk prognostication

patients

term

by
and other

innovative

under

detection

patients

syndrome;

serve
to round
out
treatment
of sepsis:

injurious

bedside

septic

tool

organ
dysfunction
response
syndrome

inflammation

stratification

of-illness
evaluation,

early

with

to assess mortality.
Appropriate
methods
and...