• Encephalopathy (reduced vigilance, restlessness, disorientation, or delirium without influence of psychotropic substances) • Thrombocytopenia (thrombocyte count ≤100,000/μl or decrease of thrombocytes > 30% in 24 h without evidence of bleeding) • Arterial hypoxemia [paO2 < 10 kPa (75 mmHg) when breathing room air or paO2/FiO2 ≤ 33 kPa (250 mmHg) not caused by pulmonary or cardiac disorder] • Arterial hypotension (systolic blood pressure ≤ 90 mmHg or mean blood pressure ≤ 70 mmHg) for at least 1 h despite adequate fluid resuscitation and absence of other types of shock • Renal dysfunction (urinary output ≤0.5 ml kg-1 h-1 for at least 1 h despite sufficient fluid resuscitation or increase of serum creatinine 2× above the reference range) • Metabolic acidosis (base deficit ≥5.0 mEq/l or serum lactate concentration 1.5 above the reference range) Septic shock • Diagnosis of infection Arterial hypotension (systolic blood pressure ≤ 90 mmHg or mean blood pressure ≤ 70 mmHg) for at least 2 h despite adequate fluid resuscitation which requires the administration of vasopressors (dopamine ≥5 μg kg− 1 min− 1; norepinephrine or epinephrine ≥0.05 μg kg− 1 min− 1; phenylephrine or vasopressin in any dosage) to maintain systolic blood pressure 90 mmHg or mean systolic pressure 70 mmHg |