TABLE 1.

Summary of Revisions Between the 2007 and 2015 Guidelines

Topic	2007 Guidelines	2015 Guidelines
Definition of “survival”	Not addressed	Defined to be a patient’s short-term likelihood of surviving the acute medical episode
Triage decision-maker	Triage officer	Triage officer or committee, depending on a facility’s resources
Exclusion criteria	Included medical conditions that required intense resources and those with high mortality, but ambiguous on when death would occur	Medical conditions limited to those associated with immediate or near-immediate mortality even with aggressive therapy (e.g., removal of renal dialysis as an exclusion criterion)
		Explicitly rejected as an exclusion criterion
DNR Order as exclusion criterion	Not addressed
SOFA score	Provided cutoff scores for each color category with a brief explanation	More detailed explanation on how the scores are used and explains how a patient is eligible for/continues ventilator therapy, based on an improvement in overall health status (i.e., the SOFA score drops with each assessment)
Time trials	Time trials after 120 hours are not addressed	Assessments conducted every 48 h
Secondary triage factors	Not addressed	Use of randomization (e.g., lottery) or young age (i.e., 17 years or younger) may be used in limited circumstances
Alternative forms of medical intervention and palliative care	Briefly addressed	More detailed discussion
Review of triage decisions	Overview of both real-time appeals and retrospective review; did not recommend a model	Hybrid system of review, combining limited on-going individual appeals with retrospective periodic review