Severe sepsis is sepsis with evidence of organ dysfunction, hypotension, or hypoperfusion, which may be shown by reduced consciousness, hypoxia, oliguria, and a serum lactate above 2 mmol/L. Septic shock includes the same features as severe sepsis but additionally involves refractory hypotension, meaning hypotension continues despite adequate fluid resuscitation, and serum lactate is above 4 mmol/L.

The handbook categorizes sepsis into severe sepsis and septic shock. Severe sepsis is defined as sepsis accompanied by organ dysfunction, hypotension, or hypoperfusion; indicators include a reduced level of consciousness, hypoxia, oliguria, and a serum lactate measurement greater than 2 mmol/L. Septic shock is a more severe category that shows the same symptoms as severe sepsis, but with two distinguishing features: refractory hypotension (hypotension that persists even after adequate fluid resuscitation) and a serum lactate measurement greater than 4 mmol/L. Both conditions require urgent review by the critical care team and may need intensive care.

Key points

Severe sepsis involves organ dysfunction, hypotension, or hypoperfusion, with lactate often over 2 mmol/L.
Septic shock adds refractory hypotension that does not correct with adequate fluid resuscitation.
Septic shock has a higher lactate threshold of over 4 mmol/L, compared with severe sepsis over 2 mmol/L.
Both severe sepsis and septic shock warrant critical care team review and possible intensive care.

What is the difference between severe sepsis and septic shock according to the Oxford Handbook of Adult Nursing?

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