Skip to main content
. Author manuscript; available in PMC: 2021 Feb 1.
Published in final edited form as: Pediatr Crit Care Med. 2020 Feb;21(2):129–135. doi: 10.1097/PCC.0000000000002106

Table 1:

Review of original paper checklist criteria and translation to PICU Warning Tool

Criterion Definition or adaptation* in PICU Warning Tool, or reason for exclusion
Unchanged High Mean Airway Pressure Mean airway pressure sustained greater than 20 cm H20 for at least 2 hours
Extracorporeal Membrane Oxygenation (ECMO) Any patient receiving veno-venous or veno-arterial ECMO (up to 24 hours post decannulation)
Adapted Pulmonary Hypertension Most recent nitric oxide gas value > 5 parts per million AND
  • Active pulmonary hypertension on problem list OR
  • Received medication indicating pulmonary hypertension in prior 24 hours
Use of two vasoactive medications OR high dose single drug Medication Administration Record within the last 6 hours of:
  • Any dose of phenylephrine, dobutamine, or vasopressin
  • Any two of the following: dopamine, epinephrine, or norepinephrine
  • Epinephrine or norepinephrine with dose>0.1 mcg/kg/min
  • Dopamine with dose >5 mcg/kg/min
Traumatic Brain Injury • Sustained elevated intracranial pressure > 20 for most recent 2 hours
• 3% saline or mannitol bolus in prior 6 hours for high ICP
PICU Initiated Renal Replacement Therapy First 5 hours on CRRT and first 5 hours off of CRRT
Potassium >7.0 Two consecutive potassium laboratory values >7 mmol/L (resulted with the last 24 hours)
pH<7.1 Most recent pH laboratory value (resulted within the past 24 hours)<7.1
Lactate>10 Most recent lactate laboratory result >10 mmol/L
Added Severe Cardiac Dysfunction • Mixed venous saturation<60% without 2 consecutive values >70% within the last 24 hours OR
• Milrinone infusion within the previous 6 hours
Excluded Stage 1 Hypoplastic Left Heart Repair in Past 24 hours HLH patients not cared for in the study PICUs
Recent life-threatening event requiring code team activation or cardiac arrest No standardized EHR documentation of events
Intubation/Extubation of known difficult or critical airway Difficult or critical airway is reliably captured at both institutions, intubation not documented until post procedure.
Provider Intuition Concern on the part of an attending physician that a patient is high-risk regardless of criteria met cannot be captured in an automated fashion.
Anticipated tracheal intubation of known diagnosis of myocarditis Tracheal intubations are only documented post procedure.
*

Adaptations noted in italics