Extracorporeal Membrane Oxygenation (ECMO) Prediction Score of Bailly et al for a Child with Respiratory Failure (Pediatric Pulmonary Rescue with ECMO Prediction, P-PREP)
Bailly et al reported a Extracorporeal Membrane Oxygenation (ECMO) prediction score for evaluating pediatric patients with respiratory failure. This can help to identify a pediatric patient who may benefit from more aggressive management. The authors are from the University of Utah, Naval Medical Center San Diego, Boston Children's Hospital, Harvard Medical School and the Extracorporeal Life Support Organization.
Patient selection: child with ECMO for respiratory failure from 8 days to < 18 years of age
Outcome: mortality
Parameters:
(1) type of ECMO
(2) number of days of mechanical ventilation
(3) PaO2 to FIO2 ratio in mm Hg
(4) arterial pH
(5) primary pulmonary diagnosis (6 choices)
(6) cardiac arrest pre-ECMO
(7) cancer
(8) acute renal failure
(9) acute liver necrosis
Parameter
Finding
Points
type of ECMO
venoarterial
0
venovenous
-4
mechanical ventilation
<= 14 days
0
> 14 days
5
PaO2 to FIO2
> 300
0
201 to 300
4
101 to 200
5
<= 100
7
pH
< 7.11
1
7.11 to 7.34
0
> 7.34
-1
primary pulmonary diagnosis
asthma
-8
aspiration
-5
respiratory syncytial virus
-4
sepsis-induced ARDS
3
pertussis
5
other
0
pre-ECMO cardiac arrest
no
0
yes
3
cancer
no
0
yes
6
acute renal disease
no
0
yes
8
acute liver necrosis
no
0
yes
18
total PPREP score =
= SUM(points for all 9 parameters)
Interpretation:
• minimum score: -13
• maximum score: 53
• The higher the score the greater the mortality rate.
X =
= (0.1196 * (score)) - 1.2769
mortality rate =
= 1 / (1 + EXP((-1) * X))
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