About: ECCO(2)R therapy in the ICU: consensus of a European round table meeting

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An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	ECCO(2)R therapy in the ICU: consensus of a European round table meeting
Creator	Sousa, Eduardo Combes, Alain Du Cheyron, Damien De Bels, David Auzinger, Georg Capellier, Gilles Clement, Ian Consales, Guglielmo Dabrowski, Wojciech Goldstein, Jacques González De Molina Ortiz, Francisco Gottschalk, Antje Harenski, Kai Hilty, Matthias Pestaña, David Tully, Redmond
Source	PMC
abstract	BACKGROUND: With recent advances in technology, patients with acute respiratory distress syndrome (ARDS) and severe acute exacerbations of chronic obstructive pulmonary disease (ae-COPD) could benefit from extracorporeal CO(2) removal (ECCO(2)R). However, current evidence in these indications is limited. A European ECCO(2)R Expert Round Table Meeting was convened to further explore the potential for this treatment approach. METHODS: A modified Delphi-based method was used to collate European experts’ views to better understand how ECCO(2)R therapy is applied, identify how patients are selected and how treatment decisions are made, as well as to identify any points of consensus. RESULTS: Fourteen participants were selected based on known clinical expertise in critical care and in providing respiratory support with ECCO(2)R or extracorporeal membrane oxygenation. ARDS was considered the primary indication for ECCO(2)R therapy (n = 7), while 3 participants considered ae-COPD the primary indication. The group agreed that the primary treatment goal of ECCO(2)R therapy in patients with ARDS was to apply ultra-protective lung ventilation via managing CO(2) levels. Driving pressure (≥ 14 cmH(2)O) followed by plateau pressure (P(plat); ≥ 25 cmH(2)O) was considered the most important criteria for ECCO(2)R initiation. Key treatment targets for patients with ARDS undergoing ECCO(2)R included pH (> 7.30), respiratory rate (< 25 or < 20 breaths/min), driving pressure (< 14 cmH(2)O) and P(plat) (< 25 cmH(2)O). In ae-COPD, there was consensus that, in patients at risk of non-invasive ventilation (NIV) failure, no decrease in PaCO(2) and no decrease in respiratory rate were key criteria for initiating ECCO(2)R therapy. Key treatment targets in ae-COPD were patient comfort, pH (> 7.30–7.35), respiratory rate (< 20–25 breaths/min), decrease of PaCO(2) (by 10–20%), weaning from NIV, decrease in HCO(3)(−) and maintaining haemodynamic stability. Consensus was reached on weaning protocols for both indications. Anticoagulation with intravenous unfractionated heparin was the strategy preferred by the group. CONCLUSIONS: Insights from this group of experienced physicians suggest that ECCO(2)R therapy may be an effective supportive treatment for adults with ARDS or ae-COPD. Further evidence from randomised clinical trials and/or high-quality prospective studies is needed to better guide decision making.
has issue date	2020-08-07(xsd:dateTime)
bibo:doi	10.1186/s13054-020-03210-z
has license	cc-by
sha1sum (hex)	e6c1ef36a1217f837ce5ebc5e2a2651afdf8e577
schema:url	https://doi.org/10.1186/s13054-020-03210-z
resource representing a document's title	ECCO(2)R therapy in the ICU: consensus of a European round table meeting
has PubMed Central identifier	PMC7412288
schema:publication	Crit Care
resource representing a document's body	covid:e6c1ef36a1217f837ce5ebc5e2a2651afdf8e577#body_text
is schema:about of	named entity 'patients' named entity 'removal' named entity 'chronic obstructive pulmonary disease' named entity 'ECCO' named entity 'acute exacerbations' named entity 'VILI' named entity 'haemodynamic' named entity 'COPD' named entity 'ARDS' named entity 'ARDS' named entity 'ECMO' named entity 'COPD' named entity 'intubation' named entity 'ICUs' named entity 'NIV' named entity 'intubated' named entity 'ARDS' named entity 'prone position' named entity 'ICUs' named entity 'COPD' named entity 'respiratory rate' named entity 'NIV' named entity 'respiratory rate' named entity 'Europe' named entity 'ARDS' named entity 'systematic literature review' named entity 'end-stage disease' named entity 'argatroban' named entity 'PEEP' named entity 'supportive treatment' named entity 'ARDS' named entity 'prospective studies' named entity 'supportive treatment' named entity 'intubated' named entity 'weaning' named entity 'chronic obstructive pulmonary disease' named entity 'ARDS' named entity 'MEDLINE' named entity 'clinical practice' named entity 'contraindicated' named entity 'ICUs' named entity 'NIV' named entity 'SUPERNOVA' named entity 'follow-up' named entity 'heparin' named entity 'ICU' named entity 'ARDS' named entity 'Brussels' named entity 'Delphi method' named entity 'invasive ventilation' named entity 'respiratory rate' named entity 'ARDS' named entity 'Weaning' named entity 'extracorporeal carbon dioxide removal' named entity 'NIV' named entity 'asthma' named entity 'weaning' named entity 'nutrition' named entity 'ECMO' named entity 'oxygen' named entity 'extubation' named entity 'weaning' named entity 'ARDS' named entity 'anticoagulant' named entity 'common criteria' named entity 'weaning' named entity 'anticoagulant' named entity 'helium'

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