The Cardiovascular
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SAVE (Survival after Veno-Arterial ECMO) Score

Predicts in-hospital survival before starting VA-ECMO for refractory cardiogenic shock.

SAVE (Survival after Veno-Arterial ECMO) Score
Age
Weight
Cause of cardiogenic shock
Chronic renal failure
Pre-ECMO HCO3 ≤15 mmol/L
Duration of mechanical ventilation before ECMO
Peak inspiratory pressure ≤20 cmH2O
Pre-ECMO cardiac arrest
Pre-ECMO diastolic BP ≥40 mmHg
Pre-ECMO pulse pressure ≤20 mmHg
Acute liver failure pre-ECMO
CNS dysfunction pre-ECMO
Result-1 points (Class III)

Approximate in-hospital survival: 42 %.

Predicted in-hospital survival
42 %

When to use

  • Estimating survival likelihood before or shortly after cannulation for refractory cardiogenic shock on VA-ECMO.

Formula

Weighted sum of 12 pre-ECMO variables (age, weight, etiology, renal function, ventilation duration, respiratory mechanics, haemodynamics, organ dysfunction) minus a constant of 6. Class I (>5) 75% survival down to Class V (≤-10) 18% survival.

Pearls and pitfalls

  • Derived from the international Extracorporeal Life Support Organization (ELSO) registry; should complement, not replace, bedside judgement on ECMO candidacy.

References

  1. Schmidt M, et al. Eur Heart J. 2015;36(33):2246-56.