Clinical Pulmonary Infection Score for ventilator-associated pneumonia (CPIS)

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When to use

Temperature (degrees C)

36.5-38.4

38.5-38.9

≥ 39.0 or ≤ 36.0

White blood cell count, mm**3

4,000-11,000

< 4,000 or > 11,000

< 4,000 or > 11,000 with band forms ≥ 500

Tracheal secretions

< 14+

≥ 14+

≥ 14+ with purulent secretions

Oxygenation, arterial partial pressure of oxygen/fraction of inspired oxygen

> 240 or adult respiratory distress syndrome

≤ 240 and no adult respiratory distress syndrome

Pulmonary radiography

No infiltrate

Diffuse or patchy infiltrate

Localized infiltrate

Culture of tracheal aspirate specimen (semi-quantitative, 0, 1, 2, or 3+)

Pathogenic bacteria cultured ≤ 1+ or no growth

Pathogenic bacteria cultured > 1+

Pathogenic bacteria cultured > 1+ with same pathogenic bacteria on Gram stain > 1+

Calculation

Please enter all the required inputs.

The Clinical Pulmonary Infection Score (CPIS) is a diagnostic tool used specifically in the intensive care unit (ICU) setting to assess the likelihood of ventilator-associated pneumonia (VAP) in patients on mechanical ventilation. The CPIS uses six clinical parameters: temperature, blood leukocyte count, tracheal secretions, oxygenation, radiographic infiltrates, and the culture of tracheal aspirate. Each parameter is scored from 0 to 2, with a higher total score indicating a higher probability of VAP. The clinical utility of the CPIS is to aid in the diagnosis of VAP, which can be challenging due to the lack of a definitive diagnostic test. It can also guide the initiation and discontinuation of antibiotic therapy in these patients, thereby reducing the risk of antibiotic resistance. The CPIS may not be applicable or accurate in patients with conditions that can mimic the signs and symptoms of VAP, such as acute respiratory distress syndrome (ARDS), pulmonary edema, or lung contusion. It should also be used with caution in immunocompromised patients, as they may not exhibit typical signs of infection.

Reference

Carolina A M Schurink, Christianne A Van Nieuwenhoven, Jan A Jacobs et al. Clinical pulmonary infection score for ventilator-associated pneumonia: accuracy and inter-observer variability. Intensive Care Med. 2004 Feb;30(2):217-224.

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