The Cardiovascular
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RESP (Respiratory ECMO Survival Prediction) score

Predicts survival before venovenous ECMO for severe acute respiratory failure.

RESP (Respiratory ECMO Survival Prediction) score
Age
Immunocompromised
Mechanical ventilation before ECMO
Acute respiratory diagnosis (select main group)
Central nervous system dysfunction
Acute associated (non-pulmonary) infection
Neuromuscular blockade before ECMO
Inhaled nitric oxide before ECMO
Bicarbonate infusion before ECMO
Cardiac arrest before ECMO
PaCO2 >=75 mmHg
Peak inspiratory pressure >=42 cmH2O
Result3 points

Risk class II; predicted survival to hospital discharge about 76 %.

Risk class
II
Predicted survival
76 %

When to use

  • Estimating survival before initiating venovenous ECMO for severe acute respiratory failure.

Formula

Sum of weighted items (range -22 to 15). Classes: >=6 (I, 92%), 3-5 (II, 76%), -1 to 2 (III, 57%), -5 to -2 (IV, 33%), <=-6 (V, 18%).

Pearls and pitfalls

  • Derived and validated in ECMO-selected patients; not a threshold to withhold ECMO on its own.

References

  1. Schmidt M, et al. Am J Respir Crit Care Med. 2014;189(11):1374-1382.