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    Attention COACH STUDY participants:

    The principal investigators of the study request that you use the official version of the modified score here.

    Murray Score for Acute Lung Injury

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

    IMPORTANT

    Tips for COVID-19: Use to determine ECMO. Standard score for determining when ECMO indicated. Used in CESAR trial, a pivotal RCT in ECMO.

    INSTRUCTIONS

    Use in patients with severe hypoxemic respiratory failure from acute respiratory distress syndrome (ARDS). May be used with other clinical factors to help select patients for extracorporeal membrane oxygenation (ECMO).

    When to Use
    Pearls/Pitfalls
    Why Use
    • Patients with severe hypoxemic respiratory failure from acute respiratory distress syndrome (ARDS).
    • May be used in conjunction with other clinical factors (e.g. age, comorbidities, etiology of respiratory failure, presence of other organ dysfunction, duration of endotracheal intubation) to help determine whether a patient may benefit from extracorporeal life support.
    • Indicates severity of ARDS; 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.
    • Provides a relatively standardized method of assessing severity of lung injury in the setting of ARDS and helps guide which patients may benefit from extracorporeal life support.
    • ECMO has expanded management options for patients with severe forms of ARDS; however, optimal criteria and timing of ECMO for initiation are unestablished. The Murray Score is one system that may help guide practitioners in selecting appropriate candidates for this treatment.
    Unknown
    None
    1 quadrant
    2 quadrants
    3 quadrants
    4 quadrants
    Unknown
    ≥300
    225-299
    175-224
    100-174
    <100
    Unknown
    ≤5
    6–8
    9–11
    12–14
    ≥15
    Unknown
    ≥80
    60–79
    40–59
    20–39
    ≤19
    Confirmed positive
    Suspected
    Unlikely
    Confirmed negative

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. John F. Murray

    About the Creator

    John F. Murray, MD, is professor emeritus of medicine at the University of California in San Francisco. He served as chief of the pulmonary and critical care division at San Francisco General Hospital. Dr. Murray’s research interests are focused on pulmonology.

    To view Dr. John F. Murray's publications, visit PubMed

    Are you Dr. John F. Murray? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    Content Contributors
    • Peter Liou, MD
    About the Creator
    Dr. John F. Murray
    Are you Dr. John F. Murray?
    Content Contributors
    • Peter Liou, MD