Culture positive infection and at least three of the following: |
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1. Fever > 39 °C |
2. Hypothermia (< 36.5 °C) |
3. Progressive tachycardia (> 110 beats per min) |
4. Progressive tachypnea (> 25 breaths per minute not ventilated or minute ventilation > 12 L/min ventilated) |
5. Thrombocytopenia (< 100,000/μl) |
6. Hyperglycemia, in the absence of preexisting diabetes mellitus (untreated plasma glucose > 200 mg/dl or > 7 units of insulin/h intravenous drip or significant resistance to insulin, > 25% increase in insulin requirement over 24 h); |
7. Inability to continue enteral feedings > 24 h (abdominal distension or high gastric residuals, residuals two times feeding rate or uncontrollable diarrhea, > 2500 ml/day) |