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Table 2 Modified Clinical Pulmonary Infection Score (mCPIS)

From: The effect of an intraoperative, lung-protective ventilation strategy in neurosurgical patients undergoing craniotomy: study protocol for a randomized controlled trial

Classification Grading basis
Grade 1 Dry cough
Atelectasis: extrapulmonary exclude other causes of body temperature> 37.5°C, or abnormal pulmonary symptoms or signs; radiological examination was normal
Difficulty in breathing (other causes excluded from the lung)
Grade 2 Cough and sputum don’ts due to other causes (heart failure, etc.)
Bronchospasm: wheeze, or the original wheeze need treatment
atelectasis: radiological evidence; body temperature> 37.5°Cor abnormal lung symptoms or signs
Transient hypercapnia requiring treatment such as naloxone; assisted or mechanical ventilation
Grade 3 Pleural effusion, pleurisy
Pneumonia, suspected: radiological evidence; no positive bacterial culture results
Pneumonia, diagnosis: radiological evidence; bacterial culture evidence
Postoperative reintubation or retention of intubation respiratory support (including noninvasive and invasive) ≤48 hrs.
Grade 4 Respiratory failure: postoperative non-invasive respiratory support ≥ 48 hours; or re-endotracheal intubation ventilator support ≥ 48hrs
  1. * Postoperative hypoxemia diagnostic criteria: suction air PaO2 < 60 mmHg, or SpO2 < 90%; or PaO2/FiO2 ≤ 300
  2. * Pneumonia diagnostic criteria: new chest radiograph or progression of infiltrative lung lesions, combined with the following two or more can be diagnosed: body temperature ≥ 38.5 °C or < 36 °C; WBC > 12 × 109 or < 4 × 109; purulent sputum and/or new or aggravated cough and expectoration
  3. * Atelectasis diagnostic criteria: atelectasis by x-ray signs: atelectasis of the lung tissue through decrease in brightness; increased homogeneity of a radiological density; bronchiectasis can be associated with non-homogeneous density (cystic translucent area) in convalescence. Different degrees of volume reduction, subsegmental and distal to the pulmonary atelectasis may have other collateral ventilation routes and volume reduction is not obvious. Leaf segmental atelectasis is generally blunt, triangular, wide and face towards the diaphragmatic pleural surface, the tip pointing to the hilum, in a fan, triangle, band, circle, etc. Computed tomography (CT) imaging above costophrenic angle 1 cm
  4. * Systemic inflammatory response syndrome (SIRS) diagnostic criteria: two or more of the following clinical manifestations: body temperature > 38 °C or < 36 °C; heart rate > 90 beats/min; WBC > 12 × 109 or < 4 × 109 or myeloblast count > 10%
  5. Diagnosis of sepsis: systemic infection: positive microbial blood culture, or tissue infection or evidence of abscess formation (such as: pneumonia, peritonitis, urinary tract infection, central venous catheter infection, soft tissue infections); at least two SIRS criteria
  6. * Criteria of diagnosis of severe sepsis: sepsis, combined with at least one organ failure, hypotension or hypoperfusion
  7. * Diagnostic criteria for Chinese toxic shock syndrome: infection-induced hypotension, although the volume of treatment but there are still important organs and tissue hypoperfusion