Send to

Choose Destination
J Crit Care. 2016 Dec;36:301-305. doi: 10.1016/j.jcrc.2016.06.014. Epub 2016 Jun 22.

Triage decisions for ICU admission: Report from the Task Force of the World Federation of Societies of Intensive and Critical Care Medicine.

Author information

Universitat Autònoma de Barcelona, CIBERes, Parc Taulí Hospital, Sabadell, Spain. Electronic address:
Lebanese American University, Beirut, Lebanon.
Bombay Hospital Institute of Medical Sciences, Mumbai, India.
Mount Sinai Hospital & University Health Network, Toronto, Canada.
The Chinese University of Hong Kong, Shatin, NT, Hong Kong.
University of New South Wales, Australia.
The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Surgical Sciences and Integrated Diagnostics, IRCCS AOU San Martino IST, University of Genoa, Genoa, Italy.
Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Hacettepe University, Ankara, Turkey.
Université Libre de Bruxelles, Belgium.
Ohio State University, Columbus, OH, USA.
Houston Methodist Hospital, Houston, TX, USA.


Demand for intensive care unit (ICU) resources often exceeds supply, and shortages of ICU beds and staff are likely to persist. Triage requires careful weighing of the benefits and risks involved in ICU admission while striving to guarantee fair distribution of available resources. We must ensure that the patients who occupy ICU beds are those most likely to benefit from the ICU's specialized technology and professionals. Although prognosticating is not an exact science, preference should be given to patients who are more likely to survive if admitted to the ICU but unlikely to survive or likely to have more significant morbidity if not admitted. To provide general guidance for intensivists in ICU triage decisions, a task force of the World Federation of Societies of Intensive and Critical Care Medicine addressed 4 basic questions regarding this process. The team made recommendations and concluded that triage should be led by intensivists considering input from nurses, emergency medicine professionals, hospitalists, surgeons, and allied professionals. Triage algorithms and protocols can be useful but can never supplant the role of skilled intensivists basing their decisions on input from multidisciplinary teams. Infrastructures need to be organized efficiently both within individual hospitals and at the regional level. When resources are critically limited, patients may be refused ICU admission if others may benefit more on the basis of the principle of distributive justice.


Allocation of resources; Health care delivery; Intensive care; Triage

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center