Table 7 Definitions and grading of organ dysfunction (MODS score)
From: Causes of death and determinants of outcome in critically ill patients
Function | No organ dysfunction/failure | Organ dysfunction | Organ failure |
|---|---|---|---|
Pulmonary | PaO2/FiO2 ratio ≥ 300 | PaO2/FiO2 ratio ≥ 250 | PaO2/FiO2 ratio <250 |
Renal | Creatinine ≤ 2.0 mg/dl | Creatinine >2.0 mg/dl; doubling of creatinine in patients with previous compensated renal failure | Continuous veno-venous haemofiltration |
Hepatic | Bilirubin <2 mg/dl; ASAT/ALAT within normal range | Bilirubin 2 to 5 mg/dl; ASAT/ALAT ≤ three times normal value | Bilirubin >5 mg/dl; ASAT/ALAT > three times normal value |
Haematologic | Thrombocytes within normal range; normal coagulation | Thrombocyte decrease ≥ 25%; abnormal PT/aPTT with and without bleeding | Haemorrhagic diathesis; massive transfusion five blood products per hour or > 10 blood products per 24 hours |
Cardiovascular | Normal blood pressure; no vasoactive drugs except dopamine ≤ 5 μg/kg per minute | Fluid resuscitation > 50% of normal need and/or dopamine >5 μg/kg per minute, dobutamine <10 μg/kg per minute, phenylephrine | Dobutamine >10 μg/kg per minute, AVP, epinephrine, norepinephrine, combination of catecholamines, IABP, VAD |
Gastrointestinal | Normal gastrointestinal function, no bleeding | Ileus >7 days or bleeding requiring ≤ six blood products per 24 hours | Massive bleeding requiring > six blood products per 24 hours |
Central nervous system | GCS ≥ 12 | GCS 9–11 | GCS ≤ 8 |