Naming and Unnaming in the Extracorporeal Membrane Oxygenation Literature

Abstract

We are grateful for the readers' interest and suggestions relevant to our original contribution entitled "Pulmonary Artery Dual-Lumen Cannulation Versus Two Cannula Percutaneous Extracorporeal Membrane Oxygenation Configuration in Right Ventricular Failure." 1 Our report uniquely compared the technique with a dual lumen cannula whose tip is positioned in the pulmonary artery to the two cannulae veno-pulmonary artery configurations for acute right ventricular support. We concluded that the dual lumen cannula technique may have better outcomes as reflected by the shorter duration of the mechanical ventilation and early mobility of the patients with acute right ventricular failure. We are aware of the challenge and the inconsistency in the literature regarding extracorporeal membrane oxygenation (ECMO) nomenclature. Hence, we elaborated on the configuration description both visually and verbally. In addition, we based our nomenclature on a large multicenter study that compared multiple configurations for COVID-19 patients supported by veno-venous ECMO. 2 Similarly, multiple publications for the two cannulas configuration. 3,4 We wholeheartedly agree that standardization of the ECMO nomenclature is beneficial to both researchers and consumers of that research. The recent expansion of ECMO and multiple new techniques will surely result in improved outcomes. However, during this rapid growth period, there will be new terms, as befits a dynamic discovery field. We wish to see a live document led by the Extracorporeal Life Support Organization (ELSO), adopted by other societies and journals and shared widely in the scientific community to guide this process and keep up with the industrial and clinical expansion. In addition, we see other aspects of ECMO management that might need priority in definition. For instance, there is an inconsistent definition of bleeding or infectious complications during ECMO support. 5,6 The authors circumvent these challenges by defining these complications either in their respective institutions or in the articles. Until then, we must continue to share our work and learn from our esteemed colleagues allowing us to improve outcomes for our patients.