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Ressources et utilitaires

Scoring systems for ICU and surgical patients:

IRISS (Ischemia / Reperfusion Injury Severity Score)

Variables (help)	Values	Points
Graft Ischemic time	< 0 -120 minutes 121-240 minutes 241-360 minutes 361-480 minutes > 480 minutes
Age (patients)	< = 30 years 31 - 40 years 41 - 50 years 51 - 60 years > 60 years
PaO2 (mmHg) / FIO2	> 250 201 - 250 151 - 200 101 - 150 51 - 100 < = 50
Early Hemodynamic Failure	No Severe
Probability of ICU death : Logit = -9.25 + (IRISS)*0.0833 Probability of ICU Death = 1/ (1 + e-Logit) e		IRISS= IRISS = Sum (points)

Reference

Thabut G et al. Primary graft failure following lung transplantation : predictive factors of mortality. Chest 2002;121:1876-82

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Patients

259 patients who underwent Lung Transplantation (LTx) over a twelve years period (from 1988 to 2000) in two LTx centers in Paris (France).

Definitions

Primary Graft Failure (PGF) was defined by the presence of reperfusion edema with or without Early Hemodynamic Failure (EHF).

Reperfusion pulmonary edema was defined by the presence of 3 criteria : 1) radiographic infiltrate in the graft that develops within the first three days following LTx ; 2) PaO2/ FIO2 ratio < 300 in the first three days following LTx ; and 3) no evidence of bacterial infection, rejection , or atelectasis.

Graft Ischemic time : From aortic clamping ( donnor) to lung revascularization (second if sequential).

PaO2 (mmHg) / FIO2 : worst ratio within the first three days following LTx.

Early Hemodynamic Failure (EHF) was defined as the need for catecholamine agents to maintain mean systemic arterial pressure > 60 mmHg. EHF was defined as moderate (dopamine requirement > 5 µg/kg.min up to 20 µg/kg.min) or severe (requiring the use of epinephrine or norepinephrine when dopamine was ineffective).

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