• Sakir Akin, Kadir Caliskan, Osama Soliman, Rahatullah Muslem, Goksel Guven, Robert J van Thiel, Ard Struijs, Diederik Gommers, Felix Zijlstra, Jan Bakker, and Dinis Dos Reis Miranda.
• Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Intensive Care, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Intensive Care, Haga Teaching Hospital, The Hague, the Netherlands. Electronic address: s.akin@erasmusmc.nl.
• J Crit Care. 2020 Feb 1; 55: 35-41.

PurposeMortality after veno-arterial extracorporeal membrane oxygenation (VA-ECMO) implantation remains a major problem in patients with cardiogenic shock. Our objective was to assess the utility of the SOFA score in combination with markers of right ventricular (RV) dysfunction in predicting mortality in the ICU.Materials And MethodsData were retrospectively obtained from all adult patients (n=103) who were treated with VA-ECMO between November 2004 and January 2016. The primary outcome of this study was ICU mortality after VA-ECMO implantation. Using the clinical, demographic and echocardiographic data, we developed a novel mortality risk score, the SOFA-RV score, which combine RV-function to the SOFA score at the time of VA-ECMO implantation.ResultsOut of 103 patients, 37 (36%) died in the ICU. The median duration of VA-ECMO support was 7 days [IQR 4-11], mean age 49 ± 16 years, and 54% were male. SOFA-RV score has an AUC of 0.70, and was significantly better than SOFA alone (AUC of 0.57) in predicting ICU mortality. In addition, SAVE and MELD scores were not able to predict ICU mortality.ConclusionAdding RV-function to the existing SOFA score improves significantly the prediction of ICU mortality in patients on VA-ECMO. Dedicated evaluation of RV function in patients with VA-ECMO is therefore recommended.Copyright © 2019 Elsevier Inc. All rights reserved.

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