PROGNOSTIC FACTORS ASSOCIATED WITH THE SUCCESS OF EXTRACORPOREAL CARBON DIOXIDE REMOVAL IN PATIENTS WITH ACUTE RESPIRATORY DISTRESS SYNDROME

Văn Cường Bùi , Ngọc Sơn Đỗ , Quốc Tuấn Đặng, Quang Trung Võ, Hữu Thông Trần, Văn Trọng Nguyễn

Main Article Content

Abstract

Objective: To identify prognostic factors associated with the success of extracorporeal carbon dioxide removal (ECCO₂R) in patients with acute respiratory distress syndrome (ARDS). Subjects: ARDS patients indicated for ECCO₂R the Center for Critical Care Medicine – Bach Mai Hospital from July 2024 to September 2025. Methods: A retrospective descriptive observational study with convenient sampling included all ARDS patients who underwent ECCO₂R during the study period; data were collected from medical records and case report forms and analyzed using SPSS. Results: A total of 15 patients with ARDS were enrolled in this study, the majority were male, with a mean age of 58,5 ± 15,1 years and a mean SOFA score of 9; 66,7% required norepinephrine support. Univariate logistic regression analysis revealed no factor reaching statistical significance; however, a favorable trend was observed in patients with a higher ventilatory ratio (VR, OR = 3,106; p = 0,145). Unfavorable factors included older age (OR = 0,24; p = 0,14), the presence of comorbidities (OR = 0,71; p = 0,55), and higher SOFA scores (OR = 0,65; p = 0,27). Conclusion: In patients with ARDS undergoing ECCO₂R, a higher VR was associated with a trend toward greater clinical success, whereas advanced age, comorbidities, and higher SOFA scores were unfavorable factors.

Article Details

References

1. Lamas T, Del Sorbo L, Fan E. Recent advances and future directions in extracorporeal carbon dioxide removal. J Clin Med. 2025; 14(1):12. doi: 10.3390/jcm14010012.
2. Vito Fanelli, Marco V. Ranieri, Jordi Mancebo, et al. Feasibility and safety of low-flow extracorporeal carbon dioxide removal to facilitate ultra-protective ventilation in patients with moderate ARDS. Critical Care. 2016;20:36. doi:10.1186/s13054-016-1211-y.
3. Combes A, Fanelli V, Pham T, Ranieri VM; for the SUPERNOVA investigators. Feasibility and safety of extracorporeal CO₂ removal to enhance protective ventilation in acute respiratory distress syndrome: the SUPERNOVA study. Intensive Care Med. 2019;45(5):592-600. doi:10.1007/s00134-019-05567-4.
4. Bein T, Weber-Carstens S, Goldmann A, et al. Lower tidal volume strategy (≈3 ml/kg) combined with extracorporeal CO₂ removal versus ‘conventional’ protective ventilation (6 ml/kg) in severe ARDS: the prospective randomized Xtravent-study.Intensive Care Med.2013;39 (5):847-856.doi:10.1007/s00134-012-2787-6.
5. McNamee JJ, Gillies MA, Barrett NA, et al. Effect of Lower Tidal Volume Ventilation Facilitated by Extracorporeal Carbon Dioxide Removal vs Standard Care on 90-Day Mortality in Patients With Acute Hypoxemic Respiratory Failure: The REST Randomized Clinical Trial. JAMA. 2021; 326(11):1013-1023. doi: 10.1001/ jama.2021.13374.
6. Elie Azoulay, Virginie Lemiale, Bruno Mourvillier, et al. Management and outcomes of acute respiratory distress syndrome patients with and without comorbid conditions. Intensive Care Med. 2018; 44(7):1050–1060. doi: 10.1007/ s00134-018-5209-6.
7. Goligher EC, Combes A, et al. Determinants of the effect of extracorporeal carbon dioxide removal in the SUPERNOVA trial: implications for trial design. Intensive Care Med. 2019;45(9): 1219–1230.