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Index of Brieva et al for Death Within 60 Minutes After Withdrawal of Cardiopulmonary Support in the ICU

Description

Brieva et al reported an index which can be used to predict if a patient in the ICU will die within 60 minutes after withdrawal of life support. The authors are from John Hunter Hospital, Hunter New England Local Health District, Calvary Mater Newcastle Hospital and University of Newcastle in Australia.


Patient selection: ICU

Parameters:

(1) spontaneous respiratory rate

(2) Glasgow coma scale (GCS)

(3) positive end-expiratory pressure (PEEP) in cm H2O

(4) systolic blood pressure in mm Hg

(5) arterial pH

(6) analgesia

 

Parameter

Finding

Points

spontaneous respiratory rate

<=10

1

 

>= 11

0

Glasgow coma scale

3

1

 

>= 4

0

PEEP

>= 11

2

 

<-10

0

systolic blood pressure

<=84

2

 

85-104

1

 

>= 105

0

arterial pH

<= 7.14

3

 

7.15-7.24

2

 

7.25-7,32

1

 

>= 7.33

0

analgesia

no

1

 

yes

0

 

total score =

= SUM(points for all 6 parameters)

 

Interpretation:

• minimum score: 0

• maximum: 10

• About half of patients with a score >= 7 died within 60 minutes.

• A seventh item is an ICU specialist's prediction of death within 60 minutes (2 points).


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