*Cardiovascular dysfunction (after fluid resuscitation with at least 40 ml/kg of crystalloid)**hypotension with blood pressure < 5th percentile for age or systolic blood pressure < 2 standard deviations below normal for age, OR**vasopressor requirement, OR**two of the following criteria:***unexplained metabolic acidosis with base deficit > 5 mEq/L***lactic acidosis: serum lactate 2 times the upper limit of normal***oliguria (urine output )***prolonged capillary refill > 5 seconds***core to peripheral temperature difference*Respiratory dysfunction (in the absence of cyanotic heart disease or known chronic lung disease)**the ratio of the arterial partial-pressure of oxygen to the fraction of oxygen in the gases inspired (PaO2/FiO2) < 300 (the definition of acute lung injury), OR**arterial partial-pressure of carbon dioxide (PaCO2) > 65 torr (20 mmHg) over baseline PaCO2 (evidence of hypercapnic respiratory failure), OR**supplemental oxygen requirement of greater than FiO2 0.5 to maintain oxygen saturation ≥ 92%*Neurologic dysfunction**Glasgow Coma Score (GCS) ≤ 11, OR**altered mental status with drop in GCS of 3 or more points in a patient with developmental delay/intellectual disability*Hematologic dysfunction**platelet count or 50% drop from maximum in chronically thrombocytopenic patients, OR**international normalized ratio (INR) > 2**Disseminated intravascular coagulation*Kidney dysfunction**serum creatinine ≥ 2 times the upper limit of normal for age or 2-fold increase in baseline creatinine in patients with chronic kidney disease*Liver dysfunction (only applicable to infants > 1 month)**total serum bilirubin ≥ 4 mg/dl, OR**alanine aminotransferase (ALT) ≥ 2 times the upper limit of normalConsensus definitions, however, continue to evolve, with the latest expanding the list of signs and symptoms of sepsis to reflect clinical bedside experience.
* Cardiovascular dysfunction (after fluid resuscitation with at least 40 ml/kg of crystalloid)** hypotension with blood pressure < 5th percentile for age or systolic blood pressure < 2 standard deviations below normal for age, OR** vasopressor requirement, OR** two of the following criteria:*** unexplained metabolic acidosis with base deficit > 5 mEq/L*** lactic acidosis: serum lactate 2 times the upper limit of normal*** oliguria (urine output < 0.5 ml/kg/hr)*** prolonged capillary refill > 5 seconds*** core to peripheral temperature difference > 3 °C* Respiratory dysfunction (in the absence of cyanotic heart disease or known chronic lung disease)** the ratio of the arterial partial-pressure of oxygen to the fraction of oxygen in the gases inspired (PaO2/FiO2) < 300 (the definition of acute lung injury), OR** arterial partial-pressure of carbon dioxide (PaCO2) > 65 torr (20 mmHg) over baseline PaCO2 (evidence of hypercapnic respiratory failure), OR** supplemental oxygen requirement of greater than FiO2 0.5 to maintain oxygen saturation ≥ 92 %* Neurologic dysfunction** Glasgow Coma Score (GCS) ≤ 11, OR** altered mental status with drop in GCS of 3 or more points in a patient with developmental delay/mental retardation* Hematologic dysfunction** platelet count < 80,000/mm³ or 50 % drop from maximum in chronically thrombocytopenic patients, OR** international normalized ratio (INR) > 2* Renal dysfunction** serum creatinine ≥ 2 times the upper limit of normal for age or 2-fold increase in baseline creatinine in patients with chronic kidney disease* Hepatic dysfunction (only applicable to infants > 1 month)** total serum bilirubin ≥ 4 mg/dl, OR** alanine aminotransferase (ALT) ≥ 2 times the upper limit of normal=== Neonatal sepsis ===In common clinical usage, sepsis specifically refers to the presence of a serious bacterial infection(SBI) (such as meningitis, pneumonia, pyelonephritis, or gastroenteritis) in the setting of fever.