murray_score v.1

Murray Score for Acute Lung Injury

Daniel Keszthelyi

models@cambiocds.com

Indicates severity of ARDS. Stratifies severity of acute lung injury, and is also used for ECMO patient selection

Murray score is calculated with the addition of the selected points, then divide by the number of inputs selected The variables are: Consolidation on chest X-ray: 1p for each quadrant PaO2/FiO2 ratio: ≥300: 0p, 225-299: 1p, 175-224: 2p, 100-174: 3p, <100: 4p Positive End-Expiratory Pressure: ≤5: 0p, 6-8: 1p, 9-11: 2p, 12-14: 3p, ≥15: 4p Compliance, ml/cm H2O: ≥80: 0p, 60-79: 1p, 40-59: 2p, 20-39: 3p, ≤19: 4p Interpretation: Murray Score Severity 0 No lung injury 0.1–2.5 Mild to moderate >2.5 Severe

Should not be used by itself to determine candidacy for ECMO. Should not be used to characterize severity of other forms of acute or chronic respiratory failure, or to assign severity to patients with ARDS manifested by severe, uncompensated respiratory acidosis. Not applicable to patients being considered for ECMO for cardiac failure.

[1] Murray JF, Matthay MA, Luce JM, Flick MR. An expanded definition of the adult respiratory distress syndrome. Am Rev Respir Dis. 1988;138(3):720-3. [2] Peek GJ, Mugford M, Tiruvoipati R, et al. Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet. 2009;374(9698):1351-63. [3] (ELSO). Extracorporeal Life Support Organization (ELSO) Guidelines for Adult Respiratory Failure. 2013. [4] Gundre PR, Shah T, Kupfer Y, et al. Murray's Acute Lung Injury Score As A Predictor Of Tracheostomy In Critically Ill Patients. Chest. 2009;136(4_MeetingAbstracts). [5] Brogan TV, Lequier L, Lorusso R et al. Extracorporeal Life Support: The ELSO Red Book, 5th edition. Extracorporeal Life Support Organization 2017.

OBSERVATION.murray_score.v0, EVALUATION.murray_assessment.v0