[Prognostic value of dynamic monitoring of different pediatric critical illness scales in children with extracorporeal membrane oxygenation assisted shock treatment].

OBJECTIVE: To investigate the predictive value of different pediatric critical illness scores for the prognosis of children with refractory shock receiving extracorporeal membrane oxygenation (ECMO) auxiliary treatment. METHODS: A retrospective case-control study was conducted. Pediatric patients admitted to the pediatric cardiac and thoracic surgery intensive care unit (ICU) at Henan Children's Hospital from January 2019 to December 2023 who received veno-arterial ECMO support for refractory shock were included. Clinical data were collected. The Pediatric Critical Illness Score (PCIS), PEdiatric Logistic Organ Dysfunction-2 (PELOD-2), and Pediatric Multiple Organ Dysfunction Score (P-MODS) were calculated based on vital signs and laboratory results at 24 hours before ECMO as well as 6 hours and 12 hours of ECMO. Pediatric patients were categorized into death and survival groups according to discharge outcomes. Differences in clinical data and the three scores between groups were compared. Receiver operator characteristic curve (ROC curve) analysis was used to assess the predictive value of the three scores for in-hospital death in ECMO-treated pediatric patients with shock. The Hosmer-Lemeshow goodness-of-fit test was used to evaluate the predictive accuracy of the three scoring systems for death. RESULTS: =1.556, P=0.906). CONCLUSIONS: PCIS, PELOD-2, and P-MODS scores before and on ECMO demonstrated predictive value and good fit for predicting in-hospital death in children with shock receiving ECMO support, and allow for continuous dynamic monitoring. Combined use of these three scores further enhances predictive value, sensitivity, and specificity.