Table 3.

ECCO₂R weaning protocol for patients with ARDS

Weaning criteria and steps for weaning for ECCO2R in ARDS*
ECCO2R will be applied for at least 48 h
PaO2/FiO2 > 200 mmHg before testing weaning possibility
Set VT at 6 mL/PBW and PEEP 5–10 cmH2O
Driving pressure should be < 14 cmH2O
Respiratory rate should be 20–30 breaths/min
Reduce gas flow to zero, using 2 L/min decremental steps
While weaning, pH should remain > 7.30 and respiratory rate < 25 breaths/min
Patient will be weaned off ECCO2R therapy after a minimum of 12 h of stability under these settings (including pH > 7.30 and respiratory rate < 25 breaths/min)

*A consensus was reached for all of these criteria and steps