Situations to distinguish:
• reversible severe damage
• irreversible initial nonfunction
Data reliability:
(1) high reliability: GOT, GPT, glutamate dehydrogenase, bile volume, histology, total oxygen consumption
(2) average reliability: FFP and fresh blood substitution, clotting factors, circulatory behavior, immunologic situation
(3) low reliability: bile color, close observation of patient's condition, intuition of decision makers, mental status
|
Variable
|
Parameter
|
Dimension Factor
|
Weighting Factor
|
|
x1
|
GPT in U/L on day 0
|
0.001
|
3.00
|
|
x2
|
GOT in U/L on day 0
|
0.001
|
-1.96
|
|
x3
|
increase in GOT in U/L from day 0 to 1
|
0.001
|
0.63
|
|
x4
|
increase in glutamate dehydrogenase in U/L from day 0 to 1
|
0.001
|
1.07
|
|
x5
|
volume of FFP and blood used on day 0
|
0.001
|
0.57
|
|
x6
|
volume of FFP and blood used on day 0
|
0.001
|
0.67
|
|
x7
|
volume of T-tube bile in ml on day 1
|
0.01
|
-1.72
|
variable x =
= (parameter value) * (dimension factor) * (weighting factor)
ischemia score =
= x1 + x2 + x3 + x4 + x5 + x6 + x7 -2.95
where:
• enzyme units are SIU
• blood is "fresh blood" and could indicate fresh whole blood
Interpretation:
• ischemia score > 0 indicates irreversible initial nonfunction
• ischemia score < 0, reversible severe damage
