Prognostic score for survival after VA ECMO for refractory cardiogenic shock
Extracorporeal membrane oxygenation (ECMO) may provide mechanical pulmonary and circulatory support for patients with cardiogenic shock refractory to conventional medical therapy. Prediction of survival in these patients may assist in management of these patients
Use SAVE score for patients receiving veno-arterial (VA) ECMO. For patients receiving veno-venous (VV) ECMO – see RESP score
Schmitd et al, 2015:
A retrospective cohort study of 3,846 patients in the ELSO registry who received VA ECMO primarily for cardiogenic shock. Of the 3,846 patients with cardiogenic shock treated with ECMO, 1601 (42%) patients were alive at hospital discharge. Chronic renal failure, longer duration of ventilation prior to ECMO initiation, pre-ECMO organ failures, pre-ECMO cardiac arrest, congenital heart disease, lower pulse pressure, and lower serum bicarbonate (HCO3) were risk factors associated with mortality. Younger age, lower weight, acute myocarditis, heart transplant, refractory ventricular tachycardia or fibrillation, higher diastolic blood pressure, and lower peak inspiratory pressure were protective. The SAVE-score (area under the receiver operating characteristics [ROC] curve [AUROC] 0.68 [95%CI 0.64–0.71]) was created. External validation of the SAVE-score in an Australian population of 161 patients showed excellent discrimination with AUROC = 0.90 (95%CI 0.85–0.95).
Matthieu Schmidt, Aidan Burrell, Lloyd Roberts, Michael Bailey, Jayne Sheldrake, Peter T. Rycus, Carol Hodgson, Carlos Scheinkestel, D. Jamie Cooper, Ravi R. Thiagarajan, Daniel Brodie, Vincent Pellegrino, David Pilcher
Chen WC, Huang KY, Yao CW, Wu CF, Liang SJ, Li CH, Tu CY, Chen HJ.
Extracorporeal membrane oxygenation (ECMO) may provide mechanical pulmonary and circulatory support for patients with cardiogenic shock refractory to conventional medical therapy. Prediction of survival in these patients may assist in management of these patients
Use SAVE score for patients receiving veno-arterial (VA) ECMO. For patients receiving veno-venous (VV) ECMO – see RESP score
Schmitd et al, 2015:
A retrospective cohort study of 3,846 patients in the ELSO registry who received VA ECMO primarily for cardiogenic shock. Of the 3,846 patients with cardiogenic shock treated with ECMO, 1601 (42%) patients were alive at hospital discharge. Chronic renal failure, longer duration of ventilation prior to ECMO initiation, pre-ECMO organ failures, pre-ECMO cardiac arrest, congenital heart disease, lower pulse pressure, and lower serum bicarbonate (HCO3) were risk factors associated with mortality. Younger age, lower weight, acute myocarditis, heart transplant, refractory ventricular tachycardia or fibrillation, higher diastolic blood pressure, and lower peak inspiratory pressure were protective. The SAVE-score (area under the receiver operating characteristics [ROC] curve [AUROC] 0.68 [95%CI 0.64–0.71]) was created. External validation of the SAVE-score in an Australian population of 161 patients showed excellent discrimination with AUROC = 0.90 (95%CI 0.85–0.95).
Matthieu Schmidt, Aidan Burrell, Lloyd Roberts, Michael Bailey, Jayne Sheldrake, Peter T. Rycus, Carol Hodgson, Carlos Scheinkestel, D. Jamie Cooper, Ravi R. Thiagarajan, Daniel Brodie, Vincent Pellegrino, David Pilcher
Chen WC, Huang KY, Yao CW, Wu CF, Liang SJ, Li CH, Tu CY, Chen HJ.
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