Table 1.

Criteria for organ failurea

a PaCO2, arterial carbon dioxide tension; AaDO2, alveolar-arterial oxygen difference; OSF, oxygen system failure; AST, asparate aminotransferase; ALT, alanine aminotransferase; INR, international normalized ratio.
CardiovascularHeart rate ≤54/min, mean arterial blood pressure ≤49 mmHg, occurrence of ventricular tachycardia and/or ventricular fibrillation or other cardiac arrhythmias requiring continuous infusion of antiarrhythmic drugs, requirement for temporary pacemaker, intra-aortic balloon pump or ventricular assist device.
NeurologicGlasgow Coma Score (GCS) <6 (noted whether sedatives were used).
RenalBlood urea nitrogen (BUN) ≥40 mg/dl or creatinine ≥2.0 mg/dl for patients with no previous history of renal disease, an increase in creatinine >1 mg/dl for patients with preexisting renal disease.
HematologicWhite blood cell count (WBC) ≤1000/mm3, platelets <20,000/mm3, hematocrit <20%, requirement for platelet transfusions to maintain >20,000/mm3
RespiratoryRespiratory rate ≤5/min or ≥49/min, PaCO2 ≥50 mmHg, AaDO2 ≥350 mmHg, ventilator-dependent after 24 h of OSF
HepaticAcute liver failure with elevations in bilirubin levels (total and direct), AST and ALT, and alkaline phosphatase greater than two times normal, increase in prothrombin time and INR of >1.5 (for patients with preexisting chronic liver disease, documented evidence of worsened liver function, and presence of encephalopathy).