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pSOFA Score

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pSOFA Score, Pediatric Sequential Organ Failure Score

  • Indications
  1. Sepsis diagnosis and severity evaluation in children
  • Precautions
  1. pSOFA Score should not be used to drive or assess specific Sepsis management
  • Criteria (based on worst available values in last 24 hours)
  1. Respiratory Function (using SpO2/FIO2 from Pulse Oximetry, or PaO2/FIO2 from ABG)
    1. Score 0: SpO2/FIO2 >=292 (or PaO2/FIO2 >400)
    2. Score 1: SpO2/FIO2 <292 (or PaO2/FIO2 <400)
    3. Score 2: SpO2/FIO2 <264 (or PaO2/FIO2 <300)
    4. Score 3: SpO2/FIO2 <220 (or PaO2/FIO2 <200) with respiratory support
    5. Score 4: SpO2/FIO2 <148 (or PaO2/FIO2 <100) with respiratory support
  2. Cardiovascular Function (using mean arterial pressure and Vasopressors)
    1. Score 0: Mean Arterial Pressure (MAP) above age related threshold
      1. Age <1 month >46 mmHg
      2. Age <11 months >55 mmHg
      3. Age <23 months >60 mmHg
      4. Age <59 months >62 mmHg
      5. Age <143 months >65 mmHg
      6. Age <216 months >67 mmHg
      7. Age >216 months (or adult) >70 mmHg
    2. Score 1: Mean Arterial Pressure (MAP) less than age related cutoff for Score 0
    3. Score 2: Dopamine <=5, OR any Dobutamine
    4. Score 3: Dopamine >5 OR Norepinephrine <=0.1 OR Norepinephrine bitartrate <=0.1
    5. Score 4: Dopamine >15 OR Norepinephrine >0.1 OR Epinephrine >0.1 OR Norepinephrine bitartrate >0.1
  3. Hepatic Function (using serum Total Bilirubin)
    1. Score 0: Serum Bilirubin <1.2 mg/dl
    2. Score 1: Serum Bilirubin 1.2 to 1.9 mg/dl
    3. Score 2: Serum Bilirubin 2.0 to 5.9 mg/dl
    4. Score 3: Serum Bilirubin 6.0 to 11.9 mg/dl
    5. Score 4: Serum Bilirubin >12 mg/dl
  4. Renal Function (using Serum Creatinine)
    1. Score 0: Serum Creatinine below age related threshold
      1. Age <1 month <0.8 mg/dl
      2. Age <11 months <0.3 mg/dl
      3. Age <23 months <0.4 mg/dl
      4. Age <59 months <0.6 mg/dl
      5. Age <143 months <0.7 mg/dl
      6. Age <216 months <1.0 mg/dl
      7. Age >216 months (or adult) <1.2 mg/dl
    2. Score 1: Serum Creatinine above age related threshold
      1. Age <1 month >0.8 mg/dl
      2. Age <11 months >0.3 mg/dl
      3. Age <23 months >0.4mg/dl
      4. Age <59 months >0.6 mg/dl
      5. Age <143 months >0.7 mg/dl
      6. Age <216 months >1.0 mg/dl
      7. Age >216 months (or adult) >1.2 mg/dl
    3. Score 2: Serum Creatinine above age related threshold
      1. Age <1 month >1.0 mg/dl
      2. Age <11 months >0.5 mg/dl
      3. Age <23 months >0.6 mg/dl
      4. Age <59 months >0.9 mg/dl
      5. Age <143 months >1.1 mg/dl
      6. Age <216 months >1.7 mg/dl
      7. Age >216 months (or adult) >2.0 mg/dl
    4. Score 3: Serum Creatinine above age related threshold
      1. Age <1 month >1.2 mg/dl
      2. Age <11 months >0.8 mg/dl
      3. Age <23 months >1.1 mg/dl
      4. Age <59 months >1.6 mg/dl
      5. Age <143 months >1.8 mg/dl
      6. Age <216 months >2.9 mg/dl
      7. Age >216 months (or adult) >3.5 mg/dl
    5. Score 4: Serum Creatinine above age related threshold
      1. Age <1 month >1.6 mg/dl
      2. Age <11 months >1.2 mg/dl
      3. Age <23 months >1.5 mg/dl
      4. Age <59 months >2.3 mg/dl
      5. Age <143 months >2.6 mg/dl
      6. Age <216 months >4.2 mg/dl
      7. Age >216 months (or adult) >5.0 mg/dl
  5. Coagulation Function (using Platelet Count)
    1. Score 0: Platelet Count >= 150 x10^3/mm3
    2. Score 1: Platelet Count < 150 x10^3/mm3
    3. Score 2: Platelet Count < 100 x10^3/mm3
    4. Score 3: Platelet Count < 50 x10^3/mm3
    5. Score 4: Platelet Count < 20 x10^3/mm3
  6. Neurologic Function (using Glasgow Coma Scale)
    1. Score 0: Glasgow Coma Scale (GCS) 15
    2. Score 1: Glasgow Coma Scale (GCS) 13 to 14
    3. Score 2: Glasgow Coma Scale (GCS) 10 to 12
    4. Score 3: Glasgow Coma Scale (GCS) 6 to 9
    5. Score 4: Glasgow Coma Scale (GCS) <6
  1. Sepsis criteria (in addition to current infection)
    1. pSOFA Score >=2 (or change in SOFA Score by 2 or more points)
  • Resources