Severe CAP vs Severe Sepsis

Severe CAP

• IDSA (Infectious Diseases Society of America)/ATS (American Thoracic Society) consensus guideline on Management of CAP in adults 2007
  
• at least one Major, or at least 3 minor

Major
1) Needs intubation (mechanical ventilation)
2) Needs vasopressors (septic shock)

9 minor (3 findings, 2 respi, 4 PLUT)
1) confusion or disorientation
2) multilobar infiltrates
3) hypotension (SBP below 90 or MAP below 65) requiring aggressive fluid resuscitation

4) RR more than 30
5) PaO2/FiO2 ratio less than 250

6) Platelet below 100
7) Leukopenia below 4k
8) Uremia >20mg/dL , 7 mmol/L
9) Temperature less than 36

Severe Sepsis

Sepsis, plus one of the following:

• Organ Dysfunction (e.g., liver/kidney/respiratory failure, or thrombocytopenia, or coagulopathy)
  
• Hypotension before fluid challenge
• Lactate ≥4 mmol/L

from consensus statement (1992) by
American College of Chest Physicians &
Society of Critical Care Medicine