ArticleAcute and critical care2026
Vasoactive-inotropic score as a predictor of clinical deterioration in pediatric patients undergoing venovenous extracorporeal membrane oxygenation: a preliminary single-center study in South Korea.
Article in Acute and critical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundVenovenous (VV) extracorporeal membrane oxygenation (ECMO) supports pediatric patients with severe respiratory failure; however, some experience clinical deterioration requiring conversion to venoarterial (VA) ECMO or resulting in mortality. The prognostic role of the vasoactive-inotropic score (VIS) at VV ECMO cannulation remains unclear.
methodsWe retrospectively analyzed pediatric patients who underwent VV ECMO between 2010 and 2024 at a single center. Baseline VIS was calculated from vasoactive infusion rates documented immediately prior to cannulation. The primary composite outcome was conversion to VA ECMO or in-hospital mortality. Associations between VIS and outcomes were assessed using correlation, univariable logistic regression, and receiver operating characteristic (ROC) analysis.
resultsTwenty patients underwent VV ECMO. Five (25.0%) required VA conversion, seven (35.0%) died, and nine (45.0%) met the composite outcome. Baseline VIS was not significantly associated with isolated mode change (r=0.13, P=0.589) and showed a borderline association with mortality (r=0.43, P=0.062). Logistic regression demonstrated a consistent direction of association between higher baseline VIS and the composite outcome (odds ratio, 1.04; 95% CI, 1.00-1.09; P=0.078). Correlation analysis also suggested an association (r=0.54, P=0.014). ROC analysis demonstrated an area under the curve of 0.79, suggesting potential discriminative ability, with an exploratory cutoff of 25.
conclusionsBaseline VIS showed a possible association with clinical deterioration in this pilot cohort. These findings are exploratory and require validation in larger prospective multicenter studies.
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