Page 121 - Critical Care Notes

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Hospital-Acquired Pneumonia Risk Index—cont’d

Factor Points Patient Patient
A B
Pulmonary No infiltrate 0
radiography:
Diffuse (or patchy) 1
infiltrate
Localized infiltrate 2
Progression of None 0
infiltrate*:
Progression (heart 2
failure and ARDS
excluded)
Growth of pathogenic No, rare, or light
bacteria on tracheal growth
aspirate culture*: 0
Moderate or heavy 1
growth
Same bacteria as on 1
Gram stain
Total
PaO 2 /FIO 2 = ratio of arterial O 2 pressure to fraction of inspired O 2 ; ARDS = acute respiratory distress
syndrome.
*Criteria applicable 72 hr after initial diagnosis.
Score >6 suggests hospital-acquired pneumonia.
Score <6 suggests alternative process.
Adapted from Singh, N, Rogers, P, Atwood, CW, et al: Short-course empiric antibiotic therapy
for patients with pulmonary infiltrates in the intensive care unit. Am J Respir Crit Care Med
162:505–511, 2000. In Beers, MH, Porter RS, Jones TV (eds): The Merck Manual, ed. 18. Merck,
Rahway, NJ, 2006.
Community-Acquired Pneumonia (CAP)
CAP is pneumonia or inflammation of the lung parenchyma that develops in
the community setting or within 48 hr of hospitalization. There are two types
of CAP:
■ Typical or bacterial: Infection by bacteria in the alveoli that cause
inflammation

RESP