{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T16:58:55Z","timestamp":1780937935685,"version":"3.54.1"},"reference-count":33,"publisher":"S. Karger AG","issue":"5","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Blood Purif"],"abstract":"<jats:p>&lt;p&gt;Introduction: Hypercapnic respiratory failure is associated with high morbidity and mortality. Low-flow extracorporeal CO&lt;sub&gt;2&lt;\/sub&gt; removal (ECCO&lt;sub&gt;2&lt;\/sub&gt;R) has been shown to facilitate lung-protective ventilation or spontaneous breathing. However, three multicenter randomized trials have failed to show benefit which could potentially be a result of patient selection. In this study, we aimed to characterize prognostic scores developed for extracorporeal membrane oxygenation therapy which could potentially assist with the selection of patients for ECCO&lt;sub&gt;2&lt;\/sub&gt;R. Methods: A total of 70 patients admitted to the intensive care unit at the University Hospital of Zurich between 10\/2009 and 02\/2017 with hypercapnic respiratory failure were treated with ECCO&lt;sub&gt;2&lt;\/sub&gt;R if pH \u22647.25 and\/or PaCO&lt;sub&gt;2&lt;\/sub&gt; \u2265 9 kPa experiencing respiratory exhaustion during spontaneous breathing in obstructive lung disease or reaching the limits of lung protective ventilation (n = 22 and n = 48) in patients with restrictive lung pathologies. Data including baseline characteristics and respiratory parameters were collected prospectively. Scores were calculated retrospectively. Results: The underlying diseases were acute respiratory distress syndrome (n = 27), chronic-obstructive pulmonary disease (n = 12), bronchiolitis obliterans syndrome (BOS; n = 9), cystic fibrosis (n = 10), pulmonary fibrosis (n = 8), and other causes (n = 4). The 180-day mortality was 45.7% with the highest rate observed in PF and BOS patients as well as in patients who had been mechanically ventilated &gt;6 days before initiation of ECCO&lt;sub&gt;2&lt;\/sub&gt;R. The modified PRedicting dEath for SEvere hypercapnic respiratory failure on vv-ECCO&lt;sub&gt;2&lt;\/sub&gt;R (PRESERVE-CO&lt;sub&gt;2&lt;\/sub&gt;) score differentiated well between survivors and non-survivors (4.3 \u00b1 2.2 vs. 6.9 \u00b1 2.6, p &lt; 0.01), whereas the modified Respiratory ECMO Survival Prediction (RESP-CO&lt;sub&gt;2&lt;\/sub&gt;) score showed no significant distinction. Receiver operating characteristics analysis of the PRESERVE-CO&lt;sub&gt;2&lt;\/sub&gt; score revealed an area under the curve of 0.78, suggesting a cut-off of 7 points. Conclusion: Careful selection of patients for ECCO&lt;sub&gt;2&lt;\/sub&gt;R therapy may help to improve outcomes. The proposed PRESERVE-CO&lt;sub&gt;2&lt;\/sub&gt; score may serve as a guide. A score of 7 points or higher is associated with an unfavorable outcome regarding the 180-day mortality in the specific patient cohort of this study, but future studies to externally validate this score are required. &lt;\/p&gt;<\/jats:p>","DOI":"10.1159\/000550776","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T17:00:54Z","timestamp":1769706054000},"page":"255-267","source":"Crossref","is-referenced-by-count":0,"title":["Prediction of Long-Term Mortality in Acute Hypercapnic Respiratory Failure with Use of Low-Flow Veno-Venous Extracorporeal CO\n                    <sub>2<\/sub>\n                    Removal: A Retrospective Single-Center Study"],"prefix":"10.1159","volume":"55","author":[{"given":"Anne-Aylin","family":"Sigg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Keiser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalimar Mila","family":"Konopasek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Klinzing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7775-3279","authenticated-orcid":false,"given":"Pedro 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