The Surviving Sepsis Campaign (SSC), defines hypotension as SBP < 90 or MAP < 65 (http://www.survivingsepsis.org/files/Tools/evaluationforseveresepsisscreeningtool.pdf) when screening a patient for severe sepsis. However, in the sepsis resuscitation bundle, one of the four standards to measure quality of fluid resuscitation is whether or not MAP is > 65. Interestingly, they do not specify that SBP be > 90, only MAP > 65. (http://www.survivingsepsis.org/About_the_Campaign/Documents/2008%20Guidelines%20Poster.pdf and http://www.survivingsepsis.org/Bundles/Individual_Changes/Pages/apply_vasopressors.aspx).
In the context of SSC sepsis resuscitation, all hypotension (SBP < 90 or MAP < 65) does not seem to be equal. It appears that SSC uses MAP, not SBP, as the hemodynamic parameter to consider, when measuring the effectiveness of fluid and vasopressor resuscitation. How do providers on this list serve practice? Do you consider the patient with MAP < 65 as hypotensive, even it her/his SBP is > 90? Is there a risk of hypoperfusion of end organs, if MAP is still < 65 while SBP > 90? Kristine Kristine Lundeen, RN, MN MultiCare Health System, Tacoma, WA Office: 253-403-1164 ________________________________ MULTICARE'S SHARED VALUES | Respect | Integrity | Stewardship | Excellence | Collaboration | Kindness Mailgate1.multicare.org made the following annotations --------------------------------------------------------------------- NOTICE: This e-mail and the attachments hereto, if any, may contain privileged and/or confidential information. It is intended only for use by the named addressee(s). If you are not the intended recipient of this e-mail, you are hereby notified that any examination, distribution or copying of this e-mail and the attachments hereto, if any, is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by email or telephone and permanently delete this e-mail and the attachments hereto, if any, and destroy any printout thereof. MultiCare Health System, Tacoma, WA 98415 (253) 403-1000. ==============================================
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