Association of clinical characteristics to mortality in acute respiratory failure patients treated with ECCO2R.

BACKGROUND

Low flow extracorporeal carbon dioxide removal (ECCO2R) 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 ECCO2R 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 ECCO2R initiation and during the first 24 h of ECCO2R therapy, patients who died had a lower PaO2/FiO2 ratio but higher FiO2, 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 FiO2 (2.33 (1.50-3.62); p < 0.001) were independently associated with increased risk of mortality.

CONCLUSIONS

Age, respiratory rate, and FiO2 during the first 24 h of ECCO2R therapy were independently associated with increased risk of hospital mortality. An ongoing high FiO2 (>0.7) and respiratory rate ⩾25 during the first 24 h is independently associated with higher risk of hospital mortality.