Sepsis, N/IICU — Severe Sepsis or Septic Shock — Clinical Pathway: ICU and Inpatient

Suspected Sepsis Clinical Pathway — N/IICU

Septic Shock or Sepsis-associated Organ Dysfunction

Congenital heart disease can present similar to sepsis. For neonates under 2 weeks of age with perfusion abnormality and hypotension, consider evaluating for a ductal dependent lesion and initiating PGE1 infusion.

If signs and symptoms concerning for infection and one or more:

  • Hypotension (could indicate septic shock)
  • Change in respiratory status
  • Perfusion abnormalities
  • Change in neurologic status
  • Coagulation abnormalities

    Heart Rate and MAP

    Evaluate prior baseline heart rate, as well as trend during 24 hours before symptom manifestation.

    Age Heart Rate MAP
    0 to 7 days 100-180 > 35*
    7-30 days 100-160 > 40
    31 days to < 1 yr 100-160 > 45
    1 yr to < 2 yr 90-160 > 50

    *Preterm Infants (< 37 Weeks Gestational Age)

    • First 72 hrs of life: MAP should be ≥ infant’s gestational age
    • After 72 hrs: MAP should be ≥ 30