cliot (version 1.0.0)

resp_ecmo_score: RESP Score for ECMO Survival Prediction

Description

Calculates the Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) score. This tool predicts in-hospital survival for adult patients undergoing ECMO for severe Acute Respiratory Distress Syndrome (ARDS). It stratifies patients into five risk classes based on 12 pre-ECMO variables.

Usage

resp_ecmo_score(age, immunocompromised, mv_duration_hours, diagnosis_category,
                cns_dysfunction, acute_infection_non_pulm, neuromuscular_blockade,
                nitric_oxide_use, bicarbonate_use, cardiac_arrest, paco2_mmhg,
                pip_cmh2o)

Value

A list containing:

RESP_Score

The calculated total score (Range -22 to 15).

Risk_Class

Risk classification (Class I to V).

Est_Hospital_Survival

Estimated in-hospital survival percentage.

Arguments

age

Numeric. Patient age in years. 18-49: 0 pts. 50-59: -2 pts. >=60: -3 pts.

immunocompromised

Numeric (0 or 1). Immunocompromised status (hematological malignancy, solid tumor, solid organ transplant, HIV, cirrhosis). (1 = Yes, -2 pts).

mv_duration_hours

Numeric. Duration of mechanical ventilation prior to ECMO initiation in hours. < 48 hours: +3 pts. 48 hours - 7 days: +1 pt. > 7 days: 0 pts.

diagnosis_category

String. Primary acute respiratory diagnosis. "viral_pneumonia", "bacterial_pneumonia", "aspiration_pneumonitis", "trauma_burn": +3 pts. "asthma": +11 pts. "other_acute_respiratory" (e.g., inhalation injury, alveolar hemorrhage): +1 pt. "chronic_non_respiratory" (e.g., chronic lung disease, non-respiratory cause): 0 pts.

cns_dysfunction

Numeric (0 or 1). Central nervous system dysfunction (neurotrauma, stroke, encephalopathy, seizure). (1 = Yes, -7 pts).

acute_infection_non_pulm

Numeric (0 or 1). Acute associated non-pulmonary infection. (1 = Yes, -3 pts).

neuromuscular_blockade

Numeric (0 or 1). Use of neuromuscular blockade agents before ECMO. (1 = Yes, +1 pt).

nitric_oxide_use

Numeric (0 or 1). Use of Nitric Oxide before ECMO. (1 = Yes, -1 pt).

bicarbonate_use

Numeric (0 or 1). Use of Bicarbonate infusion before ECMO. (1 = Yes, -2 pts).

cardiac_arrest

Numeric (0 or 1). Pre-ECMO cardiac arrest. (1 = Yes, -2 pts).

paco2_mmhg

Numeric. Partial pressure of arterial carbon dioxide in mmHg. (>= 75 mmHg: -2 pts).

pip_cmh2o

Numeric. Peak Inspiratory Pressure in cmH2O. (>= 42 cmH2O: -2 pts).

References

Schmidt M, Bailey M, Sheldrake J, et al. Predicting survival for severe ARDS patients on extracorporeal membrane oxygenation: the RESP score. Am J Respir Crit Care Med. 2014;189(11):1374-1382. doi:10.1164/rccm.201311-2023OC

Examples

# Example 1: Good Prognosis (Class I)
# 30yo (0), Asthma (+11), MV 10h (+3), NMB (+1)
# Score = 15
resp_ecmo_score(30, 0, 10, "asthma", 0, 0, 1, 0, 0, 0, 40, 30)

# Example 2: Poor Prognosis (Class IV)
# 65yo (-3), Bacterial PNA (+3), MV 8 days (0), Immuno (-2), CNS Dysfx (-7)
# Score = -9
resp_ecmo_score(65, 1, 200, "bacterial_pneumonia", 1, 0, 0, 0, 0, 0, 40, 30)