MDCalc

Lung Injury Prediction Score (LIPS)

Identifies patients at high risk for developing acute lung injury (ALI).

Predisposing Conditions

Shock
Aspiration
Sepsis
Pneumonia

High-Risk Surgery

Orthopedic spine
Acute abdomen
Cardiac
Aortic vascular
If emergency surgery

High-Risk Trauma

Traumatic brain injury
Smoke inhalation
Near drowning
Lung contusion
Multiple fractures

Risk Modifiers

Alcohol abuse
Obesity (BMI >30)
Hypoalbuminemia
Chemotherapy
FiO2 >0.35 (>4 L/min)
Tachypnea (respiratory rate >30)
SpO2 <95%
Acidosis (pH <7.35)
Diabetes mellitus (only if sepsis)

Result:

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Advice

Always interpret the score within clinical context and expertise.

Management
  • Score ≤4: Continue standard management and routine monitoring.
  • Score >4: Implement an ARDS-prevention bundle.
    • Perform close SpO₂ and work of breathing checks.
    • Employ lung-protective ventilation (≤6 mL/kg PBW, Pplat <30 cm H₂O).
    • Avoid high FiO₂ and high driving pressures.
    • Use a conservative IV fluid strategy and initiate early diuresis once shock resolves.
    • Minimise transfusions and use restrictive thresholds.
    • Treat underlying sepsis/pneumonia with appropriate antibiotic therapy.