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RESP Score for ECMO Survival Prediction

 

Input
 

Age		mo yr
PaCO2		Pascal cmH2O mmHg torr
Peak Inspiratory Pressure		Pascal cmH2O mmHg torr
	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)

 
Result
 
Important: Inputs must be complete to perform calculation.

 

RESP Score		# count index logit none number points 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

 

 

 

Notes

• 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.

 

References

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

 

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.