Please select the eligibility criteria that correspond to the clinical trial below.
Title: Pilot Feasibility and Safety Study on Low-flow Extracorporeal CO2 Removal in Patients With Moderate ARDS to Enhance Lung Protective Ventilation
Brief Summary: Pathophysiological, experimental and clinical data suggest that an '"ultraprotective" mechanical ventilation strategy may further reduce VILI and ARDS-associated morbidity and mortality. Severe hypercapnia induced by VT reduction in this setting might be efficiently controlled by ECCO2R devices. A proof-of-concept study conducted on a limited number of ARDS cases indicated that ECCO2R allowing VT reduction to 3.5-5 ml/kg to achieve Pplat\<25 cm H2O may further reduce VILI.


Options:
A: Inclusion Criteria:

* Mechanical ventilation with expected duration of \>24h
* Moderate ARDS according to the Berlin definition(16) PaO2/FiO2: 200-100 mmHg, with PEEP ≥ 5 cmH2O

Exclusion Criteria:

* Age \<18 years
* Pregnancy
* Decompensated heart insufficiency or acute coronary syndrome
* Severe COPD
* Major respiratory acidosis PaCO2\>60 mmHg
* Acute brain injury
* Severe liver insufficiency (Child-Pugh scores \>7) or fulminant hepatic failure
* Heparin-induced thrombocytopenia
* Contraindication for systemic anticoagulation
* Patient moribund, decision to limit therapeutic interventions
* Catheter access to femoral vein or jugular vein impossible
* Pneumothorax
* Platelet \<50 G/l
B: Inclusion Criteria:

* minimum of 18 and maximum of 65 years
* witnessed out-of-hospital cardiac arrest of presumed cardiac cause
* minimum of 5 minutes of ACLS performed by emergency medical service team without sustained ROSC
* unconsciousness (Glasgow Coma Score \< 8)
* ECMO team and bed-capacity in cardiac center available.

Exclusion Criteria:

* OHCA of presumed non-cardiac cause
* unwitnessed collapse
* pregnancy
* sustained ROSC within 5 minutes of ACLS performed by EMS team
* conscious patient
* known bleeding diathesis or suspected or confirmed acute or recent intracranial bleeding
* suspected or confirmed acute stroke
* known severe chronic organ dysfunction or other limitations in therapy
* "do not resuscitate" order or other circumstances making 180 day survival unlikely
* known pre-arrest cerebral performance category CPC ≥ 3.
C: Inclusion Criteria:

* The trial subjects are patients aged 18 years or older who have developed severe ARDS. Following the American-European Consensus Conference on ARDS, severe ARDS is defined as an oxygenation index (PaO2/FIO2) \< 200 mmHg. These parameters must be present for a duration of at least 2 hours.

Exclusion Criteria:

* age \< 18 years
* decompensated heart insufficiency
* acute coronary syndrome
* severe chronic obstructive pulmonary disease
* advanced tumour conditions with life expectancy \< 6 months
* chronic dialysis treatment
* lung transplant patients
* proven Heparin-induced thrombocytopenia (HIT)
* morbid obesity (BMI \>) 40
* Child Class B and C cirrhosis of the liver, acute fulminant hepatic failure
* severe peripheral arterial occlusive disease (pAVK III - IV), absence of limb doppler pulse
* brain injury (GCS \< 9 + CT pathology)
D: Inclusion Criteria:

* Invasive mechanical ventilation using positive end expiratory pressure (PEEP) ≥ 5cmH2O
* Acute and potentially reversible cause of acute respiratory failure as determined by the treating physician
* Within 48 hours of the onset of hypoxemia as defined by Pa02/Fi02 less than or equal to 20kPA

Exclusion Criteria:

* Age \< 16 years old
* Intubated and mechanically ventilated via an endotracheal or tracheostomy tube ≥ 7 days (168 hours) up to the time of randomisation
* Ability to maintain Vt to ≤ 3ml/kg PBW while maintaining pH ≥ 7.2 as determined by the treating physician
* Receiving, or decision to commence, ECMO in the next 24 hours
* Mechanical ventilation using high frequency oscillation ventilation or airway pressure release ventilation
* Untreated pulmonary embolism, pleural effusion or pneumothorax as the primary cause of acute respiratory failure
* Acute respiratory failure fully explained by left ventricular failure or fluid overload (May be determined by clinical assessment or echocardiography/cardiac output monitoring)
* Left ventricular failure requiring mechanical support
* Contra-indication to limited systemic anticoagulation with heparin
* Unable to obtain vascular access to a central vein (internal jugular or femoral vein)
* Consent declined
* Treatment withdrawal imminent within 24 hours
* Patients not expected to survive 90 days on basis of premorbid health status
* DNAR (Do Not Attempt Resuscitation) order (excluding advance directives) in place
* Severe chronic respiratory disease requiring domiciliary ventilation (except for sleep disordered breathing)
* Severe chronic liver disease (Child Pugh \>11)
* Platelet count \< 40,000 mm3 (Prior to catheter insertion)
* Previously enrolled in the REST trial
* Prisoners

Answer: A