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. 2021 Nov 16:ehab697. doi: 10.1093/eurheartj/ehab697

Table 1.

Detailed inclusion and exclusion criteria for triage in intensive care unit upon admission

Inclusion criteria:

  • Requirement for invasive ventilator support.

  • Requirement for hemodynamic support with vasoactive agents (noradrenaline-equivalent dose >0.1 μg/kg/min) or mechanical support.

  • Requirement for renal replacement therapy.

If at least one criterion is fulfilled, check for exclusion criteria.
Exclusion criteria:

  • Patients’ end of life decision preferences.

  • Unwitnessed cardiac arrest, witnessed cardiac arrest, not responsive to electrical therapy, recurrent cardiac arrest.

  • Metastatic malignant disease.

  • End-stage neurodegenerative disease.

  • Severe and irreversible neurological event or condition.

  • Chronic condition:

    • GOLD group D COPD,

    • Cystic fibrosis or pulmonary fibrosis with baseline PaO2 <55 mmHg, and

    • Cirrhosis, Child-Pugh score >7.

  • End-stage kidney disease on dialysis with refractory symptoms despite active medical management treatment.

  • Severe dementia.

  • Estimated survival <12 months.

If not even one criterion is met and ICU beds are not available, check for additional exclusion criteria.
Additional exclusion criteria to be checked if no ICU beds are available:

  • Severe trauma.

  • Severe cerebral deficits after stroke.

  • Moderate dementia (confirmed).

  • Estimated survival <24 months.

  • Chronic condition:

    • home oxygen therapy and

    • Cirrhosis with refractory ascites or encephalopathy > stage I.

  • Age >80 years.

  • Age >75 years and at least one criterion:

    • Cirrhosis,

    • Stage III chronic kidney disease KDIGO, and

    • NYHA Class >II heart failure.

If neither of these criteria is fulfilled, consider to withdraw ICU support from patients who arrived earlier to save those with better prognoses.
Criteria for little or no likelihood of benefit with ICU treatment (occurrence of at least one criterion):

  • Occurrence of two new significant organ failures not present on admission.

  • No improvement in respiratory or hemodynamic status.

  • Advanced multiple organ failure defined by an increase in SOFA score (≥25% compared to admission values after at least 10 days of treatment) associated with accumulated TISS ≥500.

COPD, chronic obstructive pulmonary disease; FEV, forced expiratory volume in 1 s; FIO, fraction of inspired oxygen; GOLD, global Initiative for chronic obstructive lung disease; ICU, intensive care unit; KDIGO, Kidney Disease: Improving Global Outcomes; NYHA, New York Heart Association; PaO2, partial pressure of arterial oxygen; SOFA, Sequential Organ Failure Assessment; SpO2, oxygen saturation measured by pulse oximetry; TISS, therapeutic intervention scoring system; TLC, total lung capacity; VC, vital capacity.