Christian et al developed criteria for triaging patients to intensive care during pandemic influenza. These included identifying patients who should not be admitted to the ICU and is applied to all patients (not just those with pandemic influenza). The authors are McMaster University, University of Toronto, the University of Hawaii and Canadian government agencies.


Criteria for exclusion from critical care - one or more of the following:

(1) age > 85 years

(2) heart failure with NYHA functional Class III or IV

(3) liver disease with a Child-Pugh score > 7

(4) COPD with FEV1 less than 25% of predicted, secondary pulmonary hypertension, or baseline PaO2 < 55 mm Hg

(5) cystic fibrosis with FEV1 less than 30% postbronchodilator or baseline PaO2 < 55 mm Hg

(6) primary pulmonary hypertension with right atrial pressure > 10 mm Hg or mean pulmonary artery pressure > 50 mm Hg

(7) pulmonary fibrosis with baseline PaO2 < 55 mm Hg, secondary pulmonary hypertension or a VC < 60% of predicted

(8) severe and irreversible neurologic condition

(9) advanced and irreversible neuromuscular disease

(10) advanced and irreversible immunodeficiency state

(11) severe baseline cognitive impairment unlikely to improve

(12) cardiac arrest that was unwitnessed, recurrent or unresponsive to pacing or defibrillation

(13) severe burns with 2 or more of the following - (a) age > 60 years, (b) > 40% of body surface area involved by severe burns, (c) smoke inhalation injury

(14) severe trauma

(15) elective palliative surgery

(16) metastatic cancer


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