Wow, we are all having a party deep in the weeds ! SBP=88mmHg with MAP=66 mmHg.
CRITERIA FOR SEPTIC SHOCK : Tissue hypoperfusion persists in the hour after crystalloid fluid administration, evidenced by either * systolic blood pressure (SBP) < 90, or * mean arterial pressure < 65 or * a decrease in systolic blood pressure by > 40 mmHg from the last previously recorded SBP considered normal for that specific patient So technically yes because Sys < 90 is a criterion - unfortunate in light of the fact that the MAP > 65 (so no vasopressors required) Clinically no - as you surmised. And yes, this measure is imperfect. Thanks, MARY ANN BARNES-DALY RN BSN CCRN DC | Clinical Performance Improvement Consultant Sutter Health - Office of Patient Experience | 2200 River Plaza Drive, Sacramento, CA 95833 Mobile 916.200.5604| Office 916.286.6717 | [email protected] "You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete." ~R. Buckminster Fuller From: Sepsisgroups [mailto:[email protected]] On Behalf Of Hoorzuk, Salome Sent: Thursday, October 15, 2015 2:47 PM To: [email protected] Subject: [Sepsis Groups] Persitent hypotension Hi Everyone Just needing your thoughts on this scenario that I encountered: If a patient's SBP historically is around the low 90's. On presentation the patient's SBP is 77 mmHg. Post fluid resuscitation the SBP=88mmHg with MAP=66 mmHg. Would the SBP of 88 mmHg be defined as persistent hypotension in light of the patient's history? Thanks Salome Salome Hoorzuk,RN Clinical Quality Specialist Quality Patient Safety and Effectiveness 300 Pasteur Drive, MC 5508 * Stanford, CA 94305 Office (650) 725 1484 Cell (650) 384 5025 Fax (650) 721-4110 [email protected]<mailto:[email protected]> [cid:[email protected]] Confidential Information: This communication and any attachments may contain confidential or privileged information for the use by the designated recipient(s) named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or the attachments is strictly prohibited. If you have received this communication in error, please contact me and destroy all copies of the communication and attachments. Thank you.
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