Cavayas YA, et al. The early change in PaCO2 after ECMO initiation is associated with neurological complications

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The largest dataset supporting a rate-of-correction effect. Its population is respiratory rather than ECPR, so it transfers by mechanism rather than by setting.

Smaller relative fall

DOI 10.1164/rccm.202001-0023oc

Large relative fall in arterial carbon dioxide in the first 24 hours (over 50%)

Retrospective; the size of the fall is largely determined by the starting value, which is itself a severity marker; two better-measured studies are null.

Median relative change minus 31%. Neurological complications 6.9% overall. A fall over 50% raised complications from 6.4% to 9.8%, adjusted OR 1.7 (1.3 to 2.3).

11,972 adults in the ELSO Registry 2012 to 2017; 88% venovenous, respiratory failure