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Systemic response to infection manifested by two or more of the following:

Temperature > 38 C or < 36 C

raised heart rate > 90 /min

tachypnoea (respiratory rate > 20 breaths/min or hyperventilation (PaCO2 < 4.25kPa))

White blood cell count > 12 x 10^9/L or < 4 x 10^9 /L or the presence of more than 10% immature neutrophils