
Abstract
We read with great interest a recent position statement on the physiology and presentation of a means of unambiguous identification of native lung and membrane lung blood flow occurring in patients supported by venoarterial extracorporeal membrane oxygenation (VA-ECMO).1 In their work, Badulak et al. provide nomenclature for three main concepts that occur as a result of the dual circulation present in patients undergoing VA-ECMO support: cannula configuration, blood flow, and the attendant effects of the presence of two areas of gas exchange (the native lung and membrane lung zones).1 Newly defined terms are proposed for concepts important to VA-ECMO physiology, including the “native lung zone,” “membrane lung zone,” “mixing point,” “differential oxygenation,” “differential carbon dioxide,” and “CO2 removal.”1 Endorsed by the Extracorporeal Life Support Organization (ELSO), this work represents an important and necessary step toward a consistent method of describing key aspects of VA-ECMO physiology in clinical practice, academics, and educational settings.1 We congratulate the author’s effort and would like to discuss the nomenclature assigned to certain oxygen saturation measurements, as further clarification on this matter is needed.1
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