ECCO2R therapy in the ICU: consensus of a European round table meeting

Table 5 ECCO₂R treatment targets and weaning protocol for patients with ae-COPD

Treatment targets for patients with ae-COPD
Parameter	Target	Score
Comfortable patient	–	27
pH	> 7.35/7.30, no consensus on specific pH	23
Respiratory rate	< 20–25 breaths/min	19
Decrease of PaCO₂ by 10–20%	–	18
Weaning from NIV	–	9
Decrease in HCO₃⁻	–	9
Maintaining haemodynamic stability	–	7
ECCO₂R weaning protocol for patients with ae-COPD
1. Patient weaned from NIV for > 6 h
a. Excluding patients on home NIV or candidates for long-term NIV
2. Intubated patients weaned from MV for > 6 h
3. SpO₂ ≥ 88% with supplemental O₂ if needed
4. Reduce sweep gas flow rate by 1–3 L/min; check arterial blood gas after 1 h for:
a. pH ≥7.35 with respiratory rate < 25 breaths/min
b. PaO₂ > 55 mmHg
c. SpO₂ > 88%
d. FiO₂ < 40%
5. Repeat sweep gas reduction until zero gas flow reached, while arterial blood gas targets maintained
6. Remove ECCO₂R after 6 h of stability of the aforementioned criteria

Treatment targets for ECCO₂R considered to be of importance and selected from the provided list. Target describes any potential target values identified. Score indicates the combined total score, with higher scores indicating a higher perceived importance. Consensus means a consensus threshold (≥ 80%) was reached, majority agreement means ≥ 50% agreed but consensus level was not reached, and no agreement means < 50% agreed. The ECCO₂R weaning protocol for patients with ae-COPD was developed and voted on during the meeting, with all attendees in agreement

ISSN: 1364-8535