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      Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

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    Patent Pending

    RESP (Respiratory ECMO Survival Prediction) Score

    Predicts in-hospital survival in adult patients after ECMO for acute respiratory failure.
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    IMPORTANT

    We launched a COVID-19 Resource Center, including a critical review of recommended calcs.

    Tips for COVID-19: Use to determine ECMO. Predicts chances of mortality after on ECMO, performing better in validations than PRESET Score. Maybe helpful as one of many factors in Crisis Standards of Care decisions. See MDCalc Review: Calcs for Resource Limited Situations.

    When to Use
    Pearls/Pitfalls
    Why Use

    • Patients receiving veno-venous (VV) and veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) for acute respiratory failure.

    • Do not use in patients receiving VA ECMO for cardiogenic shock (see SAVE Score).

    • The RESP Score only predicts survival to hospital discharge and does not predict neurologic function or functional status, which may be important considerations.

    • The score was derived from a cohort of patients who were placed on ECMO, and likely excluded many patients who may have had different survival rates.

    • Prone positioning was not included in the derivation of the RESP Score, and its effect on the predictive value of the score is unknown.

    ECMO is a resource-intensive endeavor with high morbidity, and patients should be selected carefully. Survival estimates may aid the decision process.

    18-49
    0
    50-59
    -2
    ≥60
    -3
    No
    0
    Yes
    -2
    >7 days
    0
    48 hours to 7 days
    +1
    <48 hours
    +3
    Viral pneumonia
    +3
    Bacterial pneumonia
    +3
    Asthma
    +11
    Trauma or burn
    +3
    Aspiration pneumonitis
    +5
    Other acute respiratory diagnosis
    +1
    Nonrespiratory or chronic respiratory diagnosis
    0
    No
    0
    Yes
    -7
    No
    0
    Yes
    -3
    No
    0
    Yes
    +1
    No
    0
    Yes
    -1
    No
    0
    Yes
    -2
    No
    0
    Yes
    -2
    No
    0
    Yes
    -1
    No
    0
    Yes
    -1
    Confirmed positive
    Suspected
    Unlikely
    Confirmed negative

    Result:

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    Next Steps
    Evidence
    Creator Insights

    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 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.  

    Content Contributors
    About the Creator
    Dr. Matthieu Schmidt
    Are you Dr. Matthieu Schmidt?
    Content Contributors