Table 1 Criteria for organ dysfunction

Cardiovascular

Despite intravenous application of >40 ml/kg isotonic volume in 1 hour persisting:

· Decrease in BP (hypotension) <5^th percentile for age or systolic BP < 2 SD below normal for age

· Need for vasocative drugs to maintain BP in normal range (use of dopamine in dose >5 μg/kg/min or epinephrine, norepinephrine, or dobutamine at any dose)

· Two of the following

- Metabolic acidosis (base deficit >5 mmol/l)

- Arterial lactate >2 times upper limit of normal

- Oliguria: urine output <0.5 ml/kg/h

- Prolonged capillary refill >5 sec.

- Core to peripheral body temperature difference >3°C

Respiratory

· Oxygenation index <300 in absence of cyanotic heart disease or preexisting lung disease

· PaCO₂ >65 mmHg or increase of >20 mmHg over baseline

· Proven need or FiO₂ >0.5 in order to maintain saturation ≥92%

· Need for nonelective mechanical ventilation (invasive or non-invasive)

Neurologic

· Glasgow Coma Scale (GCS) ≤11

· Acute change in mental status with decrease in GCS ≥3 points from abnormal baseline

Hematologic

· Platelet count < 80.000/mm³ or decline of 50% in platelet count from highest value recorded over the past 3 days (for chronic hematology/oncology patients)

International Normalized Ratio >2

Renal

Serum creatinine ≥ 2 times upper limit of normal for age or 2-fold increase in baseline creatinine

Hepatic

· Total bilirubin ≥ 4 mg/dL (not applicable for newborn)

ALT 2 times upper limit of normal age