SeaStar Medical Holding (ICU) 8-K Changes in Registrant's Certifying Accountant

Exhibit 16.1

November 29, 2023

Securities and Exchange Commission

100 F Street, N.E.

Washington, D.C. 20549

Commissioners:

We have read Item 4.01 of the Current Report on Form 8-K of SeaStar Medical Holding Corporation dated November 29, 2023, which we understand will be filed with the Securities and Exchange Commission, and we agree with the statements concerning our firm contained in such Form 8-K. We have no basis to agree or disagree with other statements of the registrant contained therein.

Very truly yours,

/s/ Armanino LLP

Armanino LLP

Denver, Colorado