MDCalc

SAVE (Survival after Veno-Arterial ECMO) Score

Predicts in-hospital survival in adult patients after VA ECMO for refractory cardiogenic shock.

Age, years
Weight

Etiology of cardiogenic shock

Myocarditis
Refractory VT/VF
Post heart or lung transplantation
Congenital heart disease

Renal

Acute renal failure
Defined as acute renal insufficiency (e.g. creatinine >1.5 mg/dL (132.6 µmol/L) with or without RRT
Chronic renal failure
Defined as either kidney damage or GFR <60 mL/min/1.73 m² for ≥3 months
HCO₃ before ECMO ≤15 mmol/L (91.5 mg/dL)
Worst value within 6 hrs before ECMO cannulation

Respiratory

Duration of intubation prior to initiation of ECMO, hrs
Peak inspiratory pressure ≤20 cm H₂O (≤2.0 kPa)

Cardiac

Pre-ECMO cardiac arrest
Diastolic blood pressure before ECMO ≥40 mmHg
Worst value within 6 hrs before ECMO cannulation
Pulse pressure before ECMO ≤20 mmHg
Worst value within 6 hrs before ECMO cannulation

Other organ failures pre-ECMO

Liver failure
Defined as bilirubin ≥33 µmol/L (1.9 mg/dL) or elevation of serum aminotransferases (ALT or AST) >70 UI/L
CNS dysfunction
Includes combined neurotrauma, stroke, encephalopathy, cerebral embolism, seizure/epileptic syndromes

Result:

Please fill out required fields.
Advice

Other factors may contribute to the decision to initiate ECMO (e.g. life expectancy, quality of life, resource availability).

Management

We are not aware of any guidelines that incorporate the SAVE Score, but survival prediction may be incorporated into the decision to initiate VA ECMO.

Critical Actions

Comprehensive decision-making should not be based solely on one prediction rule, and the threshold to initiate ECMO may vary by institution.  

Have feedback about this calculator?