Janota et al reported the Neonatal Multiple Organ Dysfunction (NEOMOD) score for evaluating premature infants in the neonatal intensive care unit. This can help to identify a neonate who is at high risk for mortality. The authors are from the Institute for the Care of Mother and Child in Prague.
Patient selection: premature infant in the neonatal intensive care unit (NICU)
Parameters:
(1) central nervous system changes on imaging studies
(2) hemocoagulation balance (platelet count)
(3) respiratory system
(4) gastrointestinal system
(5) cardiovascular system
(6) renal system (urine output)
(7) acid-base balance (base deficit)
|
Parameter |
Findings |
Points |
|
CNS system |
no hemorrhage OR hemorrhage limited to subependymal germinal matrix |
0 |
|
|
intraventricular hemorrhage |
1 |
|
|
intraparenchymal blood, hydrocephalus, leukomalacia, cerebral atrophy |
2 |
|
platelet count (hemocoagulation) |
> 100,000 per µL |
0 |
|
|
30,000 to 100,000 per µL |
1 |
|
|
< 30,000 per µL |
2 |
|
respiratory system |
spontaneous respirations |
0 |
|
|
need for continuous positive airway pressure OR FIO2 > 21% |
1 |
|
|
mechanical ventilation |
2 |
|
gastrointestinal system |
enteral feeding |
0 |
|
|
total parenteral nutrition (TPN) |
1 |
|
|
necrotizing enterocolitis |
2 |
|
cardiovascular system |
adequate blood pressure |
0 |
|
|
continuous pressor support to maintain adequate blood pressure |
1 |
|
|
hypotension despite pharmacological support |
2 |
|
urine output (renal system) |
> 1 mL/kg per hour |
0 |
|
|
0.2 to 1.0 mL/kg per hour |
1 |
|
|
< 0.2 mL/kg per hour |
2 |
|
base deficit (acid-base balance) |
< 7 mEq/L |
0 |
|
|
7 to 15 mEq/L |
1 |
|
|
> 15 mEq/L |
2 |
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 14
• A score >=9 was associated with 100% mortality (corresponds to 4+ organ failures).
Specialty: Critical Care, Emergency Medicine, Pedatrics
