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Table 2 Weaning from extracorporeal membrane oxygenation (ECMO)

From: Extracorporeal life support for patients with acute respiratory distress syndrome: report of a Consensus Conference

  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
  1. FECO2, oxygen fraction delivered by the extracorporeal circuit; Pplat, plateau pressure; PEEP, positive end-expiratory pressure; TV, tidal volume.