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  RESP Score for ECMO Survival Prediction

Peak Inspiratory Pressure  

Immunocompromised (-2)

CNS dysfunction (-7)

Acute nonpulmonary infection (-3)

Neuromuscular block used before ECMO (1)

Nitric oxide use before ECMO (-1)

Bicarbonate infusion before ECMO (-2)

Cardiac arrest before ECMO (-2)
On Ventilator Prior To ECMO < 48 hours (3)

48 hours to 7 days (1)

>7 days (0)
Acute Pulmonary Disease Viral or bacterial pneumonia (3)

Asthma (11)

Trauma/burn (3)

Aspiration pneumonia (5)

Other acute pulmonary disease (1)

Chronic pulmonary or nonpulmonary disease (0)

RESP Score  

Include literature references: Yes   No

  RESP Score Interpretation

6 to 15 points: Risk class I with 92% survival
3 to 5 points: Risk class II with 76% survival
-1 to 2 points: Risk class III with 57% survival
-5 to -2 points: Risk class IV with 33% survival
-22 to -6 points: Risk class V with 18% survival

  • RESP: Respiratory ECMO Survival Prediction; ECMO: extracorporeal membrane oxygenation; CNS: central nervous system.

Equations used
RESPScore = AgeFactor + PaCO2Factor + PeakInspiratoryPressureFactor + Immunocomp + OnVentilatorPriorToECMO + AcutePulmonaryDisease + CNS + NonPulmInfection + NeuromuscBlock + NitricOxide + BicarbUse + CardiacArrest


Calculation Details and Variables
  • AgeFactor is assigned values by this ordered logic:
    • If Age ≥60 yr AgeFactor = -3
    • Else if Age ≥50 yr AgeFactor = -2
    • Else AgeFactor = 0.
  • PaCO2Factor is assigned values by this ordered logic:
    • If PaCO2 ≥75 mmHg PaCO2Factor = -1
    • Else PaCO2Factor = 0.
  • PeakInspiratoryPressureFactor is assigned values by this ordered logic:
    • If Peak Inspiratory Pressure ≥42 cmH2O PeakInspiratoryPressureFactor = -1
    • Else PeakInspiratoryPressureFactor = 0.
  • Equation parameters such as On Ventilator Prior To ECMO, have two or more discrete values that may be used in the calculation. The numbers in the parentheses, e.g. (3), represent the values that will be used.

  1. Schmidt M, Bailey M, Sheldrake J, et al. Predicting survival after extracorporeal membrane oxygenation for severe acute respiratory failure. The Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) score. Am J Respir Crit Care Med. 2014 Jun 1;189(11):1374-82. PubMed ID: 24693864 PubMed Logo

Associated Medical Subject Headings [MeSH]
         Adult,   Extracorporeal Membrane Oxygenation,   Female,   Humans,   Male,   Middle Aged,   Predictive Value of Tests,   Respiratory Distress Syndrome,   Risk Factors,   Severity of Illness Index,   Survival Rate,   Treatment Outcome

Associated Logical Observation Identifiers Names and Codes [LOINC]
Parameter LOINC's and Suggested Units
Age 21612-7 : yr      21612-7 : yr      21612-7 : years      30525-0 : Years old      30525-0 : yr      30525-0 : years      
PaCO2 2019-8 : mmHg      34705-4 : mmHg      

This material contains content from LOINC® (http://loinc.org). The LOINC table, LOINC codes, and LOINC panels and forms file are copyright © 1995-2014, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and available at no cost under the license at http://loinc.org/terms-of-use.

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