Association of clinical characteristics to mortality in acute respiratory failure patients treated with ECCO ₂ R

Background: Low flow extracorporeal carbon dioxide removal (ECCO 2 R) is used to assist in lung protective ventilation. The objective of this study was to compare the characteristics of patients who died in-hospital to those who survived and identify variables pre and during the first 24 h of ECCO 2 R support independently associated with hospital mortality. Methods: This study is a multicenter, multinational, retrospective review of data from the Hemolung Registry between April 2013 and June 2021. The primary outcome was hospital mortality. Results: Of the 242 included patients 115 (48%) survived. Prior to ECCO 2 R initiation and during the first 24 h of ECCO 2 R therapy, patients who died had a lower PaO 2 /FiO 2 ratio but higher FiO 2 , respiratory rate (RR), and tidal volumes. Age ((OR: 1.51 (95% CI: 1.06–2.14); p = 0.022), RR (1.92 (1.28–2.87); p = 0.002), and FiO 2 (2.33 (1.50–3.62); p < 0.001) were independently associated with increased risk of mortality. Conclusions: Age, respiratory rate, and FiO 2 during the first 24 h of ECCO 2 R therapy were independently associated with increased risk of hospital mortality. An ongoing high FiO 2 (>0.7) and respiratory rate ⩾25 during the first 24 h is independently associated with higher risk of hospital mortality.