Septic Shock

Legacy Content

This page is about the pre-ICD10 diagnosis coding schema. See the ICD10 Diagnosis List, or the following for similar diagnoses in ICD10:Shock, septic

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Category/Organ System:	[[:Category: Cardiovasular (old)]]
Type:	[[:Category: Medical Problem (old)]][[Category: Medical Problem (old)]]
Main Diagnosis:	Septic Shock
Sub Diagnosis:	SEPTIC SHOCK
Diagnosis Code:	44-00
Comorbid Diagnosis:	No
Charlson Comorbid coding (pre ICD10):	0
Program:	Critical Care and Medicine
Status:	Currently Collected

[[Category: Cardiovasular (old)]] Mutually exclusive with Severe Sepsis

Also see Septicemia definition.

See QA Septic Shock audit started September 2009.

DEFINITION Blood pressure (BP) criteria:

1. At least one of

systolic BP < 90 mmHg for > 30 minutes and not responding to fluid resuscitation

or

or

use of vasopressor to maintain systolic BP >= 90 mmHg in the absence of other causes of shock such as hypovolemia, MI or pulmonary embolus

2. Plus at least two of:

3. Plus at least one of (organ failure):

Neuro changes: GCS < 14
Lactic Acidosis: at least one of
- LA > 2.0 or
- PH < 7.30 or
- BE < 10
Oliguria: at least one of
- urine < 0.5 cc/kg/hr or
- urine output < 30 ml / hr or
- serum creatinine increase > 40 uM from baseline
Hypoxia: at least one of
- PaO2 < 75 on RA or
- PaO2 / FiO2 ratio <280 (not valid due to pneumonia)
Coagulopathy: drop in platelets > 25% from baseline plus at least one of
- > 25% PT or
- > 25% PTT or
- NR >1.5

Septic shock (44-00) is mutually exclusive with 45-00 Severe Sepsis.