Initiation and Treatment Targets of Combes et al for Extracorporeal Carbon Dioxide Removal (ECCO2R) in an Acute Exacerbation of COPD Managed By Noninvasive Ventilation (NIV)

Patient selection: acute exacerbation of chronic obstructive pulmonary disease (COPD)

Clinical signs of a positive response to noninvasive ventilation (NIV):

(1) improved patient comfort

(2) arterial pH > 7.3

(3) decrease in respiratory rate

(4) decrease in PaCO2 by >= 10%

(5) decrease in serum bicarbonate

(6) hemodynamic stability

If these milestones are not met, then ECCO2R should be considered.