Table 7

Definitions and grading of organ dysfunction (MODS score)

Function

No organ dysfunction/failure

Organ dysfunction

Organ failure

Pulmonary

PaO₂/FiO₂ ratio ≥ 300

PaO₂/FiO₂ ratio ≥ 250

PaO₂/FiO₂ ratio <250

Renal

Creatinine ≤ 2.0 mg/dl

Creatinine >2.0 mg/dl; doubling of creatinine in patients with previous compensated renal failure

Continuous veno-venous haemofiltration

Hepatic

Bilirubin <2 mg/dl; ASAT/ALAT within normal range

Bilirubin 2 to 5 mg/dl; ASAT/ALAT ≤ three times normal value

Bilirubin >5 mg/dl; ASAT/ALAT > three times normal value

Haematologic

Thrombocytes within normal range; normal coagulation

Thrombocyte decrease ≥ 25%; abnormal PT/aPTT with and without bleeding

Haemorrhagic diathesis; massive transfusion five blood products per hour or > 10 blood products per 24 hours

Cardiovascular

Normal blood pressure; no vasoactive drugs except dopamine ≤ 5 μg/kg per minute

Fluid resuscitation > 50% of normal need and/or dopamine >5 μg/kg per minute, dobutamine <10 μg/kg per minute, phenylephrine

Dobutamine >10 μg/kg per minute, AVP, epinephrine, norepinephrine, combination of catecholamines, IABP, VAD

Gastrointestinal

Normal gastrointestinal function, no bleeding

Ileus >7 days or bleeding requiring ≤ six blood products per 24 hours

Massive bleeding requiring > six blood products per 24 hours

Central nervous system

GCS ≥ 12

GCS 9–11

GCS ≤ 8

Modified from [48]. ALAT, alanin-aminotransferase; aPTT, activated thromboplastin time; ASAT, aspartat-aminotransferase; AVP, arginine vasopressin; FiO₂, fractional inspiratory oxygen concentration; GCS, Glasgow Coma Scale; IABP, intra-aortic balloon pump; MODS, multiple organ dysfunction syndrome; PaO₂, arterial oxygen tension; PT, prothrombin time; VAD, ventricular assist device.

Mayr et al. Critical Care 2006 10:R154   doi:10.1186/cc5086