status●
ASA-classificatie Kennisonderwerp
?ASA Physical Status Classification System
| ASA physical status[1] | I | II | III | IV | V | VI |
| Definition | Healthy | Mild systemic disease |
Severe systemic disease: substantive functional limitations | Severe systemic disease that is a constant threat to life |
Moribund patient who is not expected to survive without operation |
Declared brain-dead whose organs are being removed for donor purposes |
| Age | > 3 months to < 65 years | ≤ 3 months or ≥ 65-84 years | Premature infant PremCA <60 weeks or ≥ 85 years |
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| Functional class | FC I: Complete without distres |
No functional limitations or vital organ involvement FC II: Rest at completion because of distress |
Functional limitations FC III: Stop en route because of distress |
Constant potential threat to life FC IV: Unable to do |
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| Medical status | Non organic, physiologic or psychiatric disturbance | Single/multiple systemic diseases with good control | One or more moderate to severe diseases | End stage diseases and not expected to survive within 24 hours | Clinically dead whose organs are being removed for donor purposes | |
| CVS | HT with BP ≤ 140/90 mmHg | HT ≥ 180/110 mmHg, history (>3months) of MI, CAD/stents, implanted PM, EF moderate reduction | Recent (<3months) MI, CAD/stents, ongoing ischemia or severe valve dysfunction, severe reduction of EF, uncontrolled arrhythmia with hemodynamic instability, CHF |
Ruptured abdominal/thoracic aneurysm, S/P CPR | ||
| Respiratory |
Non smoking | Current smoker, mild lung disease, well controlled asthma, OSA | Poorly controlled COPD, asthmatic attack > 2/week, severe OSA | Asthma with acute exacerbation, OSA with pulmonary HT, ARDS | ||
| CNS |
well controlled epilepsy, Parkinsonism, dementia, Alzeihmer's disease |
history (>3months) of CVA, TIA, poor-control neurological disease |
Recent (<3months) CVA, TIA. Intracranial bleed with mass effect | |||
| Endocrine |
Well controlled DM, hypo/hyper thyroidism with clinical euthyroid | Poorly controlled DM, symptomatic hypo/hyper thyroid | DKA, HHNK (Hyperglycemic Hyperosmolar Nonketotic Syndrome), thyroid crisis |
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| Hematology |
Anemia (Hct<30%), thalassemia minor eg. trait, Hb E, Hb CS,Hb H | Symptomatic anemia (Hct<25%), thalassemia major, Tromb <50, INR ≥1.5 | Tromb <50,000, INR ≥1.5 with bleeding | |||
| Renal |
Renal impairment stage 1-2, electrolyte imbalance without symptoms | CKD stage 3-4, ESRD undergoing regular scheduled dialysis, symptomatic electrolyte imbalance | ARD or ESRD not undergoing regular scheduled dialysis or volume overload, uremia, hepatorenal syndrome | |||
| GI |
minimal alcohol use |
social drinker, cirrhosis child A |
Alcohol dependence or abused, cirrhosis child B |
active hepatitis, cirrhosis child C | Ischemic bowel in the face of significant cardiac pathology or multiple organ/system dysfunction, hepatic encephalopathy | |
| Obstetric |
Normal pregnancy | Pre existing disease in pregnancy, GDM | Eclampsia, severe PE, GDM (poor-control) | HELLP syndrome | ||
| Metabolic |
BMI 25-30 BMI< 16.5 malnutrition |
BMI ≥ 40 (obesity) | BMI ≥ 45 (morbid obesity) | |||
| Others |
SIRS, hypoalbuminemia (<2.5) | Septicemia | Sepsis, DIC, shock, blunt trauma (hemodynamic stable) without inotropic drugs | Massive trauma, blunt trauma, hemodynamic instability with inotropic drug |