A calculator put together, for interest only, of various ECMO prognosis calculators. They might be wrong. Check everything.
VV ECMO Prognostic Scores
PRESERVE, PRESET, RESP, ECMOnet and Roch risk-stratification models
Version 1.0.0
Patient and pre-ECMO history
Immunocompromised
Prone positioning before ECMO
Influenza pneumonia (Roch)
Central nervous system dysfunction
Acute associated non-pulmonary infection
Neuromuscular blockade before ECMO
Nitric oxide before ECMO
Bicarbonate infusion before ECMO
Cardiac arrest before ECMO
Ventilation, haemodynamics and laboratory values
Interpret with caution
These are population-derived prognostic and risk-stratification models, not standalone ECMO candidacy rules. PRESERVE was derived in adults with severe acute respiratory distress syndrome treated with venovenous ECMO; PRESET in adults with severe acute respiratory distress syndrome treated with venovenous ECMO; RESP in adults receiving ECMO for severe acute respiratory failure; ECMOnet in influenza A(H1N1)-associated acute respiratory distress syndrome; and Roch in severe acute respiratory distress syndrome patients referred for ECMO. Apply each model only with regard to its derivation population and clinical context.
PRESERVE
PRESET
RESP
ECMOnet
Roch
Unable to calculate
No clinical values are intentionally saved by this control.
Equations
PRESERVE
Score = age points (45–55: +2; >55: +3) −2 if BMI >30 +2 if immunocompromised +1 if SOFA >12 +1 if pre-ECMO mechanical ventilation >6 days +1 if not prone positioned +2 if PEEP <10 cmH₂O +2 if plateau pressure >30 cmH₂O; minimum score 0.Six-month survival classes: 0–2 ≈97%; 3–4 ≈79%; 5–6 ≈54%; ≥7 ≈16%.
PRESET
Score = MAP points (≤70: 4; >70–80: 3; >80–90: 2; >90–100: 1) + lactate points (>10: 4; >6–10: 3; >3–6: 2; >1.5–3: 1) + pH points (≤7.10: 3; >7.10–7.20: 2; >7.20–7.30: 1) + platelet points (≤100: 2; >100–200: 1) + hospital-day points (3–7: 1; >7: 2).Intensive care unit survival risk classes: 0–5 ≈74%; 6–9 ≈32%; 10–15 ≈7%.
RESP
Score = age (18–49: 0; 50–59: −2; ≥60: −3) −2 immunocompromised + ventilation duration (<48 h: +3; 48 h–7 d: +1; >7 d: 0) + diagnosis (viral pneumonia +3; bacterial pneumonia +3; asthma +11; trauma/burn +3; aspiration +5; other acute respiratory +1; non-respiratory/chronic respiratory 0) −7 CNS dysfunction −3 acute associated non-pulmonary infection +1 neuromuscular blockade −1 nitric oxide −2 bicarbonate infusion −2 cardiac arrest −1 PaCO₂ ≥75 mmHg −1 peak inspiratory pressure ≥42 cmH₂O.Survival classes: ≥6 ≈92%; 3–5 ≈76%; −1 to 2 ≈57%; −5 to −2 ≈33%; ≤−6 ≈18%.
ECMOnet
Score = hospital-day points (<4: 0.5; 4–7: 1; 8–11: 1.5; >11: 2) + bilirubin points in mg/dL (>0.15: 0.5; >0.65: 1; >1.15: 1.5; >1.65: 2; >2.15: 2.5) + creatinine points in mg/dL (>0.50: 0.5; >0.80: 1; >1.10: 1.5; >1.40: 2; >1.70: 2.5; >2.00: 3; >2.30: 3.5) + haematocrit points (>40: 0.5; >35–40: 1; >30–35: 1.5; ≤30: 2) + MAP points (≤60: 1; >60–90: 0.5; >90: 0).A score ≥4.5 indicates higher predicted mortality. Derived in influenza A(H1N1)-associated acute respiratory distress syndrome.
Roch
Score = SOFA points (9–11: 1; ≥12: 2) +1 if age ≥45 years +1 if influenza pneumonia is absent.Cohort-specific hospital survival bands: 0–2 ≈60%; 3–4 ≈7%.
Unit conversions
PaCO₂ (mmHg) = PaCO₂ (kPa) / 0.133322; creatinine (mg/dL) = creatinine (µmol/L) / 88.4; bilirubin (mg/dL) = bilirubin (µmol/L) / 17.1.Conversions are performed before applying RESP or ECMOnet thresholds.
References
- Schmidt M, Bailey M, Sheldrake J, Hodgson C, Aubron C, Rycus PT, 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;189(11):1374-82. PMID: 24693864 DOI: 10.1164/rccm.201311-2023OC
- Schmidt M, Zogheib E, Rozé H, Repesse X, Lebreton G, Luyt CE, et al. The PRESERVE mortality risk score and analysis of long-term outcomes after extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. Intensive Care Med. 2013;39(10):1704-13. PMID: 23907497 DOI: 10.1007/s00134-013-3037-2
- Hilder M, Herbstreit F, Adamzik M, Beiderlinden M, Bürschen M, Peters J, et al. Comparison of mortality prediction models in acute respiratory distress syndrome undergoing extracorporeal membrane oxygenation and development of a novel prediction score: the PREdiction of Survival on ECMO Therapy-Score (PRESET-Score). Crit Care. 2017;21:301. PMID: 29233160 DOI: 10.1186/s13054-017-1888-6
- Pappalardo F, Pieri M, Greco T, Patroniti N, Pesenti A, Arcadipane A, et al. Predicting mortality risk in patients undergoing venovenous ECMO for ARDS due to influenza A (H1N1) pneumonia: the ECMOnet score. Intensive Care Med. 2013;39:275-81. PMID: 23160769 DOI: 10.1007/s00134-012-2747-1
- Roch A, Hraiech S, Masson E, Grisoli D, Forel JM, Boucekine M, et al. Outcome of acute respiratory distress syndrome patients treated with extracorporeal membrane oxygenation and brought to a referral center. Intensive Care Med. 2014;40:74-83. PMID: 24170143 DOI: 10.1007/s00134-013-3135-1
- Roch A, Lepaul-Ercole R, Grisoli D, Bessereau J, Brissy O, Castanier M, et al. Extracorporeal membrane oxygenation for severe influenza A (H1N1) acute respiratory distress syndrome: a prospective observational comparative study. Intensive Care Med. 2010;36(11):1899-905. PMID: 20721530 DOI: 10.1007/s00134-010-2021-3