The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease.
Failure
Pediatric Sequential Organ Failure Assessment (pSOFA) Score
The SOFA score at admission is useful for predicting outcomes in the Paediatric Intensive Care Units (PICUs) and is more accurate than SIRS for definition of paediatric sepsis.
NYHA and Modified Ross Heart Failure Classification for Children
The Ross Heart Failure Classification was developed to provide a global assessment of heart failure severity in infants, and has subsequently been modified to apply to all pediatric ages. The modified Ross Classification incorporates feeding difficulties, growth problems, and symptoms of exercise intolerance into a numeric score comparable with the NYHA classification for adults.
The Sequential Organ Failure Assessment (SOFA) Score
The SOFA system was created in a consensus meeting of the European Society of Intensive Care Medicine in 1994 and further revised in 1996. The SOFA is a six-organ dysfunction/failure score measuring multiple organ failure daily. Each organ is graded from 0 (normal) to 4 (the most abnormal), providing a daily score of 0 to 24 points. The objective in the development of the SOFA was to create a simple, reliable, and continuous score easily obtained in every institution.
Indications of Dialysis in Renal Failure
Indications of dialysis in acute renal failure (ARF)
- Severe fluid overload
- Refractory hypertension
- Uncontrollable hyperkalemia
- Nausea, vomiting, poor appetite, gastritis with hemorrhage
- Lethargy, malaise, somnolence, stupor, coma, delirium, asterixis, tremor, seizures,
- Pericarditis (risk of hemorrhage or tamponade)
- bleeding diathesis (epistaxis, gastrointestinal (GI) bleeding, etc.)
- Severe metabolic acidosis
- Blood urea nitrogen (BUN) > 70 – 100 mg/dl
Guidelines for Urinary Indices in Acute Renal Failure (ARF)
Guidelines for urinary indices whereby established Acute Renal Failure (ARF) can be distinguished from renal vasoconstriction with intact tubular function (prerenal azotemia).
Criteria for Chronic Respiratory Failure in Infants and Children
Criteria for Chronic Respiratory Failure due to Cardiopulmonary Disorders in Infants and Children
Clinical criteria
- Decreased inspiratory breath sounds
- Increased retractions, use of accessory muscles
- Cyanosis breathing room air
- Decreased level of normal activity/function
- Poor weight gain (mass) (IMPORTANT)
Knaus Criteria for Multiple System Organ Failure (MSOF)
Multiple systems organ failure is said present when more than one of the system dysfunctions detected by test values exceeding the threshold values.
King´s College Hospital Criteria for Liver Transplantation in Fulminant Hepatic Failure
In acetaminophen-induced fulminant hepatic failure, survival correlated with arterial blood pH, peak prothrombin time, and serum creatinine–a pH less than 7.30, prothrombin time greater than 100 s, and creatinine greater than 300 mumol/L indicating a poor prognosis.
NYHA Functional Classification for Congestive Heart Failure
The New York Heart Association (NYHA) Functional Classification provides a simple way of classifying heart disease (originally cardiac failure), useful for preoperative assessment. It places patients in one of four categories, based on how much they are limited during physical activity: