Table 4 Stopping criteria during weaning from V–V ECMO
From: Physiological adaptations during weaning from veno-venous extracorporeal membrane oxygenation
Parameter | Values of concern | Downsides |
|---|---|---|
Oxygen saturation | < 88% | Late sign of distress |
Heart rate | > 110 | Multifactorial causes |
PaCO2 | New respiratory acidosis | Late sign of distress |
Respiratory rate | > 35 | Late sign of distress |
Tidal volume | > 8 ml/kg IBW | Depends on respiratory system elastance |
Driving pressure | > 15 cm H2O | Evaluates both lung and chest wall |
P 0.1 | > 10 cmH2O | May be falsely low in patients with respiratory muscle weakness |
∆Peso | < − 15 cmH2O | Requires an oesophageal catheter |
Pocc | < − 20 cmH2O | Requires multiple manual manoeuvres |
Pmusc* | > 10 cmH2O | Requires measurement (or estimation) of chest wall elastance |
∆PL | > 20 cmH2O | Requires oesophageal catheter |
Total lung stress (PEEPL + ∆PL) | Unknown | Difficult assessment of PEEPL in patients with abdominal contraction |