Lee et al developed the Transport Risk Index of Physiologic Stability (TRIPS) to evaluate newborn infants requiring emergency transport. An updated version (TRIPS-II) can function as a neonatal illness severity score. The authors are from the University of Toronto, University of Alberta in Edmonton, and other institutions in Canada.
Parameters:
(1) temperature
(2) respiratory status
(3) systolic blood pressure
(4) response to noxious stimuli
Parameter
Finding
Points
temperature
< 36.1°C
5
36.1 - 37.6°C
0
> 37.6°C
5
respiratory status
severe dysfunction (apnea, gasping, intubated)
23
none, mild or moderate
0
systolic blood pressure
< 30 mm Hg
13
30 - 40 mm Hg
8
> 40 mm Hg
0
response to noxious stimuli
none, seizure, muscle relaxant
13
lethargic response, no cry
5
withdraws vigorously, cries
0
where:
• Changes from the original TRIPS include (a) reducing categories in temperature and respiratory status, (b) changing cutoff for systolic blood pressure, and (c) changing point assignment.
total TRIPS-II score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 54
• The higher the TRIPS the higher the 7-day mortality rate.
• A change in TRIPS-II at 12 hours is associated with outcome. An increase is associated with increased mortality and a decrease is associated with decreased mortality compared to an infant for whom the score does not change.
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