| Weaning trial | Criteria for ECMO withdrawal |
---|---|---|
Venovenous ECMO | FECO2 = 21% | Pplat < 25 to 30 cmH2O with TV around 6 ml/kg and PEEP < 12 cmH2O |
 | Sweep gas flow 1 L/minute or stopped | and PaO2 > 70 mmHg on FiO2 < 60% or PaO2/FiO2 > 200 mmHg |
 | Duration: several hours | and pH > 7.3 with PCO2 < 50 mmHg |
 |  | and no acute cor pulmonale |
Arteriovenous ECMO | FECO2 = 21% | Pplat < 25 to 30 cmH2O with TV around 6 ml/kg and PEEP < 12 cmH2O |
 | Sweep gas flow 1 L/minute | and PaO2 > 70 mmHg on FiO2 < 60% or PaO2/FiO2 > 200 mmHg |
 | Reduce pump blood flow by steps of 0.5 L/minute | and pH > 7.3 with PCO2 < 50 mmHg |
 | Duration: several hours | and no acute cor pulmonale |
 |  | without left ventricular failure: |
 |  | left ventricular ejection fraction > 25 to 30% |
 |  | velocity-time integral > 12 cm |