Essential Aspects of Sepsis SOFA Score Guidelines
Sepsis is a life-threatening condition that occurs when the body's response to an infection damages its own tissues and organs. The Sepsis-related Organ Failure Assessment (SOFA) score is a tool used to assess the severity of sepsis and organ dysfunction.
The SOFA score is calculated by assigning points to six physiological variables: respiratory system, cardiovascular system, hepatic system, coagulation system, renal system, and neurological system. Each variable is assessed on a scale of 0 to 4, with a higher score indicating more severe organ dysfunction.
Respiratory System
The respiratory system is assessed based on the PaO2/FiO2 ratio. A ratio of less than 200 indicates severe respiratory dysfunction and a score of 4.
Cardiovascular System
The cardiovascular system is assessed based on mean arterial pressure (MAP). A MAP of less than 70 mmHg or requiring vasopressors to maintain a MAP of 65-70 mmHg indicates severe cardiovascular dysfunction and a score of 4.
Hepatic System
The hepatic system is assessed based on the bilirubin level. A bilirubin level of greater than 12 mg/dL or an INR of greater than 1.5 indicates severe hepatic dysfunction and a score of 4.
Coagulation System
The coagulation system is assessed based on the platelet count. A platelet count of less than 100,000/µL or an INR of greater than 1.5 indicates severe coagulation dysfunction and a score of 4.
Renal System
The renal system is assessed based on the serum creatinine level. A serum creatinine level of greater than 2 mg/dL or an oliguria of less than 500 mL/day indicates severe renal dysfunction and a score of 4.
Neurological System
The neurological system is assessed based on the Glasgow Coma Scale (GCS). A GCS score of less than 11 indicates severe neurological dysfunction and a score of 4.
The total SOFA score is the sum of the scores for each of the six variables. A SOFA score of 2 or less indicates low risk of mortality, a score of 3-9 indicates moderate risk of mortality, and a score of 10 or more indicates high risk of mortality.
It's important to note that the SOFA score is only one part of the assessment of sepsis. Other factors, such as the patient's age, comorbidities, and source of infection, should also be considered when making treatment decisions.
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