Ressources et utilitaires

Scoring systems for ICU and surgical patients:

SNAP-PE (Score for Neonatal Acute Physiology - Perinatal Extension) 

Mean B.P. (mmHg), maximum < or = 65 66 - 80 81 - 100 > 100	Mean B.P. (mmHg), minimum > 35 30 - 35 20 - 29 < 20	Temperature > 35.5 °C 35 - 35.5 °C 33.3 - 34.9 °C < 33.3 °C .......... > 96 °F 95 - 96 °F 92 - 94.9 °F < 92 °F
Heart Rate, maximum < 180 180 - 200 201 - 250 > 250	Heart Rate, minimum > 90 80 - 90 40 - 79 < 40	Respiratory rate < 60 60 - 100 > 100
PaO2 (mmHg) > 65 50 - 65 30 - 50 < 30	PaO2/ FIO2 (FIO2 in %) > 3.5 2.5 - 3.5 0.3 - 2.49 < 0.3	PaCO2 (mmHg) < 50 50 - 65 66 - 90 > 90
Oxygenation Index (help) < 0.07 0.07 - 0.20 0.21 - 0.40 > 0.4	Hematocrit , maximum < 66 66 - 70 > 70	Hematocrit , minimum > 35 30 - 35 20 - 29 < 20
W.B.C. (/ microL) > 5000 2000 - 5000 < 2000	Immatures Ratio (help) < or = 0.21 > 0.21	Absolute neutrophils > or = 1000 500 - 999 < 500
Platelets (/ microL) > 100.000 30 - 100.000 < 30.000	B.U.N. ( mg/dL ) < 40 40 - 80 > 80 .......... ( mmol/L ) < 6.66 6.66 - 13.32 > 13.32	Creatinine ( mg/dL ) < 1.2 1.2 - 2.4 2.5 - 4.0 > 4.0 ......... ( micromol/L ) < 106 106 - 212 213 - 353 > 353
Urine Output (mL/kg/h) > 0.9 0.5 - 0.9 0.1 - 0.49 < 0.1	Indirect Bilirubin if > 2 kg < 15 mg/dL 15 - 20 mg/dL > 20 mg/dL < 256 micromol/L 256 - 342 micromol/L > 342 micromol/L ........................ if< = 2 kg < 5 mg/dL/kg 5 - 10 mg/dL/kg > 10 mg/dL/kg < 85 micromol/L/kg 85 - 171 micromol/L/kg > 171 micromol/L/kg	Direct Bilirubin ( mg/dL ) < 2.0 > = 2.0 .......... ( micromol/L ) < 34.2 > = 34.2
Sodium (mEq/L) maximum < 150 150 - 160 161 - 180 > 180	Sodium (mEq/L) minimum > 130 120 - 130 < 120	Stool Guaiac negative positive
Potassium (mEq/L) maximum < 6.6 6.6 - 7.5 7.6 - 9.0 > 9.0	Potassium (mEq/L) minimum > 2.9 2.0 - 2.9 < 2.0	Glucose maximum ( mg/dL ) < 150 150 - 250 > 250 ........... ( mmol/L ) < 8.3 8.3 - 13.9 > 13.9
Bicarbonate (mEq/L) maximum < 33 > = 33	Bicarbonate (mEq/L) minimum > 15 11 - 15 < = 10	Glucose minimum ( mg/dL ) > 40 30 - 40 < 30 .............. ( mmol/L ) > 2.22 1.66 - 2.22 < 1.66
Calcium (Ionised, max) < 1.4 mg/dL > = 1.4 mg/L .................. < 0.35 mmol/L >= 0.35 mmol/L	Calcium (Total, max) < 12.0 mg/dL > = 12.0 mg/dL .................. < 3 mmol/L > = 3 mmol/L	Serum pH > 7.30 7.20 - 7.30 7.10 - 7.19 < 7.10
Calcium (Ionised, min) > 1.0 mg/dL 0.8 - 1.0 mg/dL < 0.8 mg/dL .................. < 0.25 mmol/L 0.2 - 0.25 mmol/L < 0.2 mmol/L	Calcium (Total, min) > 6.9 mg/dL 5.0 - 6.9 mg/dL < 5.0 mg/dL .................. > 1.72 mmol/L 1.25 - 1.72 mmol/L < 1.25 mmol/L	SNAP =
Apnea none responsive to stim. unresponsive complete	Seizures none single multiple

Perinatal Extension

Birth weight < = 749 g 750 - 999 g > = 1000 g	Predicted death rate = Birth weight g	logit = -14.6889 +(8.6774 * (1/ (birthweight in kilograms))) +(1.4414 * (1 if Apgar at 5 minutes < 7, 0 if Apgar >= 7) + (1.0898 * (1 if <5th% for gestational age, 0 if >= 5th% for gestational age) + (0.7422 * (SNAP) * (1 if SNAP <= 15, 0 if SNAP > 15)) + (0.6251 * (SNAP) * (1 if SNAP >= 16 and <=20, 0 if SNAP < 16 or > 20)) +(0.4674 * (SNAP) * (1 if SNAP >= 21 and <=27, 0 if SNAP < 21 or > 27)) + (0.4073 * (SNAP) * (1 if SNAP >= 28, 0 if SNAP < 28 )) - (0.5429 * (SNAP/birthweight) * (1 if SNAP <= 15, 0 if SNAP > 15)) -(0.4088 * (SNAP/birthweight) * (1 if SNAP >= 16 and <=20, 0 if SNAP < 16 or > 20)) -(0.2809 * (SNAP/birthweight) * (1 if SNAP >= 21 and <=27, 0 if SNAP < 21 or > 27)) - (0.2399 * (SNAP/birthweight) * (1 if SNAP >= 28, 0 if SNAP < 28 )) Predicted Death Rate= e(logit) / (1 + e(logit))
Apgar Score at 5 min < 7 > = 7
Small for Gestational Age (help on following) < 5 th %. >5 th %.
SNAP-PE =

 

Week gestation		Weight at 5th% for body weight = g
weight at 5th% for body weight = -0.06217*(weeks)4+7.585979*(weeks)3 -337.3942*(weeks)2 +6583.4774*(weeks)-47312.4

 
Ref : Richardson DK. Birth weight and illness severity : independent predictors of neonatal mortality. Pediatrics. 1993;91:969-75
Richardson DK et al. Score for Neonatal Acute Physiology : a physiologic severity index for neonatal intensive care. Pediatrics. 1993;91:617-23

 

Immatures cells ratio = Sum (promyelocytes, myelocytes, metamyelocytes, bands-stabs) / ( total neutrophil count)

Limitations: The immature-to-total neutrophil ratio assumes that the findings are consequent to a left shift in neutrophilia and that there is no leukemia.

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  Oxygenation Index

Mean Airway PressuremmHg	Oxygenation Index =
PaO2mmHg
FIO2 (ex: 0.6)
formula: (PAW * FIO2) / PaO2

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