| Henri-Mondor Protocol calculator | ||||||||||
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| Pre | Post |
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| ECMOα | ECMO$ | ||||||||
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| Step |
| H0 | H1 | H2 | H4 | H6 | H8 | H10 | H12 |
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| PCO2, mmHg£ |
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| ABG are sampled at least 15 min after any change in minute ventilation or sweep gas flow PaCO2 from ABG at H0 is used to adjust SGF at H1; PaCO2 from ABG at H1 is used to adjust SGF at H2 ,etc… | |||||||||
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| SGF, L/min | 1 |
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| ↑ SGF(L/min) according to PaCO2 (mmHg) : +2 if PaCO2 > 60 mmHg; +1 L/min if PaCO2 35-60 mmHg; no change if PaCO2 < 35 mmHg | ||||||||
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| PEEP, cmH2O |
| PEEP lowered to 12 cmH2O at H0 if PEEP was > 12 cmH2O pre ECMO | |||||||
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| Plateau pressure (Pplat), cmH2O |
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| Tidal volume (VT), mL |
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| If Pplat >24 cmH2O with PEEP≤ 12 cmH2O: ↓ VT -(1500/RR) mL until Pplat ≤ 24 cmH2O | ||||||||
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| Respiratory rate (RR), bpm |
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| If Pplat ≤ 24 cmH2O : ↓ RR: -(1500/VT) bpm | ||||||||
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| Mode |
| VAC | Switch to BIPAP/APRV as soon as Pplat ≤ 24 cmH2O, driving pressure ≤ 12 cmH2O, PEEP = 12 cmH2O and respiratory rate ≤ 20/min | ||||||
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| α Fill in the pre ECMO column with the last arterial blood gases before VV-ECMO and the clinical parameters at time of sampling. | |||||||||
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| $ Prerequisites for sampling post ECMO blood gas (H0): i) Connect ECMO to wall medical gas; ii) If patient brought in by the mobile unit, switch ECMO machine from transport console to regular console and switch the ventilator from transport ventilator to ICU ventilator. | |||||||||
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| £ ABG are sampled at least 15 min after any change in minute ventilation or sweep gas flow | |||||||||
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| The green boxes are to be filled in to calculate the changes to be made for: sweep gas flow, tidal volume and respiratory rate | ||||||||
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| The yellow boxes give the automatically calculated values for: sweep gas flow, tidal volume and respiratory rate. | ||||||||