{"id":2553,"date":"2009-03-02T02:17:00","date_gmt":"2009-03-02T02:17:00","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/infmsof\/"},"modified":"2025-05-14T19:11:27","modified_gmt":"2025-05-14T19:11:27","slug":"infmsof","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/infmsof\/","title":{"rendered":"Knaus Criteria for Multiple System Organ Failure (MSOF)"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Multiple systems organ failure is said present when more than one of the system dysfunctions detected by test values exceeding the threshold values.<\/p>\n<p><!--more--><\/p>\n<p class=\"MsoNormal\"><strong> Acute Organ System Dysfunction<\/strong><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Respiratory failure (presence of one or more):<\/p>\n<ul>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Respiratory frequency &lt;5, &gt;49 (&gt;two years of age)<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Alveolar-arterial difference in O2 &gt;350 mmHg or PaO2\/ Fi02 &lt;200 (without congenital cardiac lesion)<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Requires mechanical ventilatory support &gt;24 h<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">PaCO2, &gt;50 mmHg and pHa &lt;7.25<\/p>\n<\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Circulatory failure (presence of one or more):<\/p>\n<ul>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Heart rate &lt;50\/mm or episode of ventricular tachycardia\/fibrillation<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Mean systemic arterial pressure &lt;50 mmHg and (or) systolic systemic arterial pressure &lt;60 mmHg<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Cardiac Index &lt;2 L\/min per sq. meter of body surface (acute onset) and (or) pHa &lt;7.25, PaCO2, &lt;35 without respiratory failure<\/p>\n<\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Renal failure (presence of one or more):<\/p>\n<ul>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Urine volume 9.3 mL\/kg body weight per hour for 8 h<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Serum creatinine &gt;266 umol\/L<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Urea nitrogen &gt;1.00 g\/L or urea &gt;0.60 g\/L<\/p>\n<\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Hepatic failure (presence of both):<\/p>\n<ul>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Bilirubin &gt;60 mg\/L or a twofold increase in alkaline phosphatase in serum <em> and<\/em><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Prothrombin time &gt;4 s over upper limit of normal range or a twofold increase in aspartate aminotransferase in serum<\/p>\n<\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Hematologic failure (presence of one or more):<\/p>\n<ul>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Leukocytes &lt;1500\/mL or &gt;40000\/mL<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Platelets &lt;20000\/mL or evidence of ongoing disseminated intravascular coagulation<\/p>\n<\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Neurologic failure<\/p>\n<ul>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Glasgow Coma Scale &lt;6 (without sedation)<\/p>\n<\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Uncontrolled sepsis (presence of one or more):<\/p>\n<ul>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Positive blood culture despite antibiotic therapy<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Fever &gt;39.5 \u00b0C (rectal temp) for &gt;24 h or spikes on three successive days<\/p>\n<\/li>\n<\/ul>\n<div class=\"Section1\">\n<div class=\"Section1\">\n<div class=\"Section1\">\n<div class=\"Section1\">\n<div class=\"Section1\">\n<div class=\"Section1\">\n<p>&nbsp;<\/p>\n<p class=\"MsoNormal\"><strong>References:<\/strong><\/p>\n<ol>\n<li class=\"MsoNormal\">Knaus WA, Draper EA, Wagner DP, Zimmerman JE. Prognosis in acute organ-system failure. Ann Surg. 1985 Dec;202(6):685-93. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/4073980\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li class=\"MsoNormal\">Marsh HM. Metabolic integrity of specific organ systems. Clin Chem. 1990 Aug;36(8 Pt 2):1547-51. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/2387065\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<\/div>\n<div class=\"Section1\"><\/div>\n<div class=\"Section1\">Created: Jan 30, 2007<\/div>\n<div class=\"Section1\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<p><\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[148],"tags":[16,15,674,901,1344,1691,1690,1689,469,1374,507,1375],"class_list":["post-2553","post","type-post","status-publish","format-standard","hentry","category-critical-care","tag-criteria","tag-criterios","tag-failure","tag-fallo","tag-infectious","tag-knaus","tag-msof","tag-multiorganico","tag-multiple","tag-organ","tag-system","tag-uti"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2553","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2553"}],"version-history":[{"count":4,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2553\/revisions"}],"predecessor-version":[{"id":9446,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2553\/revisions\/9446"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2553"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2553"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2553"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}