Organ system Definition of dysfunction Cardiovascular Despite administration of isotonic IV fluid bolus of at least 40 mL/kg in hr, presence of ANY of the following: • Hypotension 5 mEq/L) • Increased arterial lactate >2ì upper limit of normal ã Oliguria: Urine output 5 sec • Core to peripheral temperature gap >3°C Respiratory Presence of ANY of the following: • PaO2 /FiO2 65 Torr or 20 mm Hg over baseline PaCO2 • Proven need for >50% FiO2 to maintain saturation >92% • Need for nonelective invasive or noninvasive mechanical ventilation Neurologic Presence of EITHER: • Glasgow coma score ≤11 • Acute change in mental status with a decrease in Glasgow coma score ≥3 points from abnormal baseline Hematologic Presence of EITHER: • Platelet count 2 Renal Presence of EITHER: • Serum creatinine 2ì upper limit of normal for age ã Twofold increase in baseline creatinine Hepatic Presence of EITHER: • Total bilirubin ≥4 mg/dL (not applicable for newborn)