Critical care resource allocation: trying to PREEDICCT outcomes without a crystal ball

Despite pandemic influenza's long reign atop the list of potential medical catastrophes, the first protocol designed to support critical care triage in a pandemic was published only in 2006. InFACT (the International Forum of Acute Care Trialists) was formed in 2009 and provided a platform for international critical care research collaboration during the 2009-2010 Influenza A(H1N1) pandemic. Over the past 2 years, a number of working groups have emerged from InFACT focused upon improving the investigation and care of patients with severe respiratory illness. Arising from these efforts, in June of 2012, an international group of clinicians convened the first meeting of the PREEDICCT (Providing Resources for Effective and Ethical Decisions In Critical Care Triage) study group. The group's aim is to develop decision support tools appropriate for use in triaging critically ill adult patients during epidemics, mass-casualty scenarios or other resource limited settings. This meeting identified a number of knowledge gaps and research priorities in this area, and suggested a revised framework for the requirements of an adequate triage decision support tool.