To all
I Have a question regarding determining severe sepsis with pneumonia. Often,
patients who present with pneumonia do not get a blood gas. So, if you are
utilizing the criteria for hypoxic respiratory failure with pneumonia:
* Acute lung injury with PaO2/FIO2 < 200 in the presence of pneumonia as
infection source (If there is another accepted definition for acute hypoxic
respiratory failure in a non Intubated patient I'd love to see it by the way)
Doing the math, you would need a person to come in with a room air PaO2 of 42
to meet this definition.
* (FIO2)200 = PaO2 so (0.21)200 = 42
According to my extraordinary RT's conversion sheet, at a pH of 7.4 this would
be a saturation of 77% on room air. At 7.2 pH it would be a room air sat of 66%
So I would guess the ER would get a gas on that person anyway but, if someone
comes in with pneumonia and has a room air sat of 85%:
1. Would you call this an organ failure or would you stick to the above
definition?
2. Is there another definition utilizing oxygen saturations in pneumonia to
call something hypoxemic respiratory failure and thus SEVERE SEPSIS
Thanks,
Lee
Lee A. Maddox, M.D.
Medical Director of Pulmonary Services, Wellspan
Division Chief Pulmonary and Critical Care Medicine, Wellspan
Site Director, Wellspan Lung, Sleep, and Critical Care
Phone 717-851-2939
Pager 717-751-9517
Fax - 717-851-6446
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