Table 3.
The P-PREP Score at ECMO Initiation for Pediatric Respiratory Failure
| Prognostic Variables | Adjusted odds ratio (95% CI) | Score |
|---|---|---|
| Veno-arterial ECMOa | Reference | 0 |
| Veno-venous ECMO | 0.62 (0.52, 0.73) | −4 |
| Mechanical ventilation ≤14 days | Reference | 0 |
| Mechanical ventilation > 14 days | 1.84 (1.38, 2.45) | 5 |
| PaO2/FiO2 ratio | ||
| > 300 mmHg | Reference | 0 |
| 201–300 | 1.64 (0.70, 3.83) | 4 |
| 101–200 | 1.78 (0.89, 3.59) | 5 |
| ≤ 100 | 2.31 (1.21, 4.40) | 7 |
| pH | ||
| < 7.11 vs. 7.11–7.34 | 1.16 (0.96, 1.41) | 1 |
| > 7.34 vs. 7.11.–7.34 | 0.84 (0.69, 1.03 | −1 |
| Primary pulmonary diagnoses (select only one) | ||
| All other | ------------------- | 0 |
| Asthma | 0.39 (0.24, 0.66) | −8 |
| Aspiration | 0.55 (0.34, 0.89) | −5 |
| Respiratory syncytial virus | 0.62 (0.47, 0.82) | −4 |
| Sepsis induced ARDSb | 1.39 (1.10, 1.75) | 3 |
| Pertussis | 1.88 (1.22, 2.90) | 5 |
| Comorbid conditions | ||
| Pre-ECMO cardiac arrest | 1.44 (1.16, 1.80) | 3 |
| Cancer | 2.07 (1.37, 3.13) | 6 |
| Acute renal failure | 2.66 (2.17, 3.26) | 8 |
| Acute liver necrosis | 8.61 (2.97, 24.90) | 18 |
| Year of ECMO | 0.97 (0.95, 0.99) | – |
| Total Score | −13 to 53 |
An online calculator is available at www.picuscientist.org/pprep
The prediction equation is: exp(Score/8.358–1.2769)/(1+ exp(Score/8.358–1.2769)).
a
Veno-arterial is used for any mode using an arterial cannula
b
Restricted to patients without additional pulmonary infections
ARDS = acute respiratory distress syndrome according to Berlin definitions; CI = confidence interval; ECMO = extracorporeal membrane oxygenation; P-PREP = pediatric pulmonary rescue with extracorporeal membrane oxygenation prediction