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