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We developed a mathematical model of acid\u2010base balance during extracorporeal therapy using ECCO<jats:sub>2<\/jats:sub>R and continuous venovenous hemofiltration (CVVH) devices applied in series for the treatment of mechanically ventilated AKI patients. Published data from clinical studies of mechanically ventilated AKI patients treated by CVVH at known infusion rates of substitution fluid without ECCO<jats:sub>2<\/jats:sub>R were used to adjust the model parameters to fit plasma levels of arterial partial pressure of carbon dioxide (PaCO<jats:sub>2<\/jats:sub>), arterial plasma bicarbonate concentration ([HCO<jats:sub>3<\/jats:sub>]), and plasma pH (as well as certain other unmeasured physiological variables). The effects of applying ECCO<jats:sub>2<\/jats:sub>R at an unchanged and a reduced tidal volume on PaCO<jats:sub>2<\/jats:sub>, [HCO<jats:sub>3<\/jats:sub>] and plasma pH were then simulated assuming carbon dioxide removal rates from the ECCO<jats:sub>2<\/jats:sub>R device measured in the clinical studies. Agreement of such model predictions with clinical data was good whether the ECCO<jats:sub>2<\/jats:sub>R device was positioned proximal or distal to the CVVH device in the extracorporeal circuit. Although carbon dioxide removal rates from the ECCO<jats:sub>2<\/jats:sub>R device measured in one previous clinical study were higher when it was placed proximal to the CVVH device, suggesting that such in\u2010series positioning was optimal, the current mathematical model demonstrates that proximal positioning of the ECCO<jats:sub>2<\/jats:sub>R device also results in lower bicarbonate (and, therefore, total carbon dioxide) removal from the distal CVVH device. Thus, the removal of total carbon dioxide by such extracorporeal circuits is relatively independent of the position of the in\u2010series devices. It is concluded that the described mathematical model has quantitative accuracy; these results suggest that the overall acid\u2010base balance when using ECCO<jats:sub>2<\/jats:sub>R and CVVH devices in a single extracorporeal circuit will be similar, independent of their in\u2010series position.<\/jats:p>","DOI":"10.1111\/aor.13969","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T17:48:46Z","timestamp":1619632126000},"page":"1036-1049","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Modeling acid\u2010base balance for in\u2010series extracorporeal carbon dioxide removal and continuous venovenous hemofiltration devices"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6811-3472","authenticated-orcid":false,"given":"John K.","family":"Leypoldt","sequence":"first","affiliation":[{"name":"Nalecz Institute of Biocybernetics and Biomedical 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