The type of organ system supported within a CRITICAL CARE PERIOD. This may not necessarily be support for a failing organ. Basic respiratory support will frequently occur prior to advanced respiratory support. If they are both required on the same day, only advanced respiratory support must be recorded. Basic cardiovascular support will frequently occur prior to advanced cardiovascular support. If they are both required on the same day, only advanced cardiovascular support must be recorded.

National Codes:

01	Basic Respiratory Support. Indicated by one or more of the following: More than 50% oxygen delivered by face mask. Close observation due to the potential for acute deterioration to the point of needing advanced respiratory support (eg severely compromised airway or deteriorating respiratory muscle function). Physiotherapy or suction to clear secretions at least two hourly, whether via tracheostomy, minitracheostomy, or in the absence of an artificial airway. Patients recently extubated after a prolonged period of intubation and mechanical ventilation via an endotracheal tube for more than 24 hours. Mask continuous positive airway pressure or non-invasive ventilation. Patients who are intubated to protect the airway but needing no ventilatory support and who are otherwise stable.
02	Advanced Respiratory Support. Indicated by: Invasive mechanical ventilatory support (excluding mask / hood continuous positive airway pressure (CPAP) or mask pressure support ventilation (BiPAP) or CPAP applied via a trans-laryngeal tracheal tube).
03	Basic Cardiovascular Support. Indicated by one or more of the following: Treatment of circulatory instability due to hypovolaemia from any cause Use of a central venous pressure line for monitoring of central venous pressure and/or the provision of central venous access to deliver titrated fluids to treat hypovolaemia. Use of an arterial line for basic monitoring of arterial pressure or sampling of arterial blood. Single intravenous vasoactive drug used to support arterial pressure, cardiac output or organ perfusion. Intravenous drugs to control cardiac arrhythmias. Non-invasive measurement of cardiac output (e.g. echocardiography, thoracic impedance)
04	Advanced Cardiovascular Support. Indicated by one or more of the following: Multiple intravenous vasoactive and/or rhythm controlling drugs when used simultaneously to support or control arterial pressure, cardiac output or organ perfusion (eg inotropes, amiodarone, nitrates). Patients resuscitated after cardiac arrest where critical care is considered clinically appropriate. Observation of cardiac output and derived indices (e.g. pulmonary artery catheter, lithium dilution, pulse contour analyses, oesophageal doppler). Intra aortic balloon pumping and other assist devices. Insertion of a temporary cardiac pacemaker (criteria valid for each day of connection to a functioning external pacemaker unit). Placement of a gastrointestinal tonometer
05	Renal Support. Indicated by: Acute renal replacement therapy (e.g. haemodialysis, haemofiltration etc.) or the provision of renal replacement therapy to a chronic renal failure patient who is requiring other acute organ support in a critical care situation.
06	Neurological Support. Indicated by one or more of the following: Central nervous system depression sufficient to prejudice the airway and protective reflexes, excepting that caused by sedation prescribed to facilitate mechanical ventilation or poisoning (e.g. self administered overdose, alcohol, drugs, etc.) Invasive neurological monitoring e.g. intracranial pressure, jugular bulb sampling, external ventricular drain. Severely agitated or epileptic patients requiring constant nursing attention and/or heavy sedation. Continuous intravenous medication to control seizures and/or continous cerebral monitoring. Therapeutic hypothermia using cooling protocols or devices.
07	Gastrointestinal Support. Indicated by: Feeding with parenteral or enteral nutrition.
08	Dermatological Support. Indicated by one or more of the following: Patients with major skin rashes, exfoliation or burns (eg greater than 30% body surface area affected). Use of multiple trauma dressings (eg multiple limb or limb and head dressings). Use of complex dressings (e.g. large skin area greater than 30% body surface area, open abdomen, vacuum dressings or large trauma such as multiple limb or limb and head dressings).
09	Liver Support. Indicated by: Extracorporeal liver replacement device, bioartificial liver or charcoal haemoperfusion.

 

This attribute is also known by these names:

Context	Alias
plural	ORGAN SYSTEMS SUPPORTED