Position paper on the physiology and nomenclature of dual circulation during venoarterial ECMO in adults

Jenelle Badulak; Darryl Abrams; Andrew M. Luks; Bishoy Zakhary; Steven A. Conrad; Robert Bartlett; Graeme MacLaren; Leen Vercaemst; Roberto Lorusso; Lars Mikael Broman; Cara Agerstrand; Susanna Price; Alain Combes; Giles Peek; Eddy Fan; Kiran Shekar; John Fraser; Daniel Brodie; Extracorporeal Life Support Organization (ELSO)

doi:10.1007/s00134-024-07645-8

Position paper on the physiology and nomenclature of dual circulation during venoarterial ECMO in adults

Jenelle Badulak^*
, Darryl Abrams
, Andrew M. Luks
, Bishoy Zakhary
, Steven A. Conrad
, Robert Bartlett
, Graeme MacLaren
, Leen Vercaemst
, Roberto Lorusso
, Lars Mikael Broman
, Cara Agerstrand
, Susanna Price
, Alain Combes
, Giles Peek
, Eddy Fan
, Kiran Shekar
, John Fraser
, Daniel Brodie
, Extracorporeal Life Support Organization (ELSO)

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

Abstract

When native blood flow through the aorta from the adult heart and lungs meets retrograde blood flow from an artificial heart and lung during venoarterial extracorporeal membrane oxygenation (VA-ECMO), the result is the creation of two separate circulations on either side of the blood flow mixing point. This phenomenon is known as dual circulation and is characterized by different content of oxygen and carbon dioxide between the circulations. There is currently a lack of clarity surrounding the nomenclature to describe this physiologic phenomenon in VA-ECMO and thus we endeavor to name and define these terms to facilitate clear communication and proper clinical management of these patients.

Original language	English
Pages (from-to)	1994-2004
Number of pages	11
Journal	Intensive Care Medicine
Volume	50
Issue number	12
DOIs	https://doi.org/10.1007/s00134-024-07645-8
Publication status	Published - 1 Nov 2024

Keywords

Extracorporeal membrane oxygenation
Extracorporeal life support
Dual circulation
Differential oxygenation
Differential carbon dioxide
Mixing point
EXTRACORPOREAL MEMBRANE-OXYGENATION
VENTRICULAR DISTENSION
HARLEQUIN SYNDROME
MANAGEMENT

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1 Erratum / corrigendum

Correction: Position paper on the physiology and nomenclature of dual circulation during venoarterial ECMO in adults
Badulak, J., Abrams, D., Luks, A. M., Zakhary, B., Conrad, S. A., Bartlett, R., MacLaren, G., Vercaemst, L., Lorusso, R., Broman, L. M., Agerstrand, C., Price, S., Combes, A., Peek, G., Fan, E., Shekar, K., Fraser, J., Brodie, D. & Extracorporeal Life Support Organization (ELSO), Mar 2025, In: Intensive Care Medicine. 51, 3, p. 661-662 2 p.
Research output: Contribution to journal › Erratum / corrigendum › Academic

Open Access

Cite this

Badulak, J., Abrams, D., Luks, A. M., Zakhary, B., Conrad, S. A., Bartlett, R., MacLaren, G., Vercaemst, L., Lorusso, R., Broman, L. M., Agerstrand, C., Price, S., Combes, A., Peek, G., Fan, E., Shekar, K., Fraser, J., Brodie, D., & Extracorporeal Life Support Organization (ELSO) (2024). Position paper on the physiology and nomenclature of dual circulation during venoarterial ECMO in adults. Intensive Care Medicine, 50(12), 1994-2004. https://doi.org/10.1007/s00134-024-07645-8

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title = "Position paper on the physiology and nomenclature of dual circulation during venoarterial ECMO in adults",

abstract = "When native blood flow through the aorta from the adult heart and lungs meets retrograde blood flow from an artificial heart and lung during venoarterial extracorporeal membrane oxygenation (VA-ECMO), the result is the creation of two separate circulations on either side of the blood flow mixing point. This phenomenon is known as dual circulation and is characterized by different content of oxygen and carbon dioxide between the circulations. There is currently a lack of clarity surrounding the nomenclature to describe this physiologic phenomenon in VA-ECMO and thus we endeavor to name and define these terms to facilitate clear communication and proper clinical management of these patients.",

keywords = "Extracorporeal membrane oxygenation, Extracorporeal life support, Dual circulation, Differential oxygenation, Differential carbon dioxide, Mixing point, EXTRACORPOREAL MEMBRANE-OXYGENATION, VENTRICULAR DISTENSION, HARLEQUIN SYNDROME, MANAGEMENT",

author = "Jenelle Badulak and Darryl Abrams and Luks, \{Andrew M.\} and Bishoy Zakhary and Conrad, \{Steven A.\} and Robert Bartlett and Graeme MacLaren and Leen Vercaemst and Roberto Lorusso and Broman, \{Lars Mikael\} and Cara Agerstrand and Susanna Price and Alain Combes and Giles Peek and Eddy Fan and Kiran Shekar and John Fraser and Daniel Brodie and \{Extracorporeal Life Support Organization (ELSO)\}",

year = "2024",

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doi = "10.1007/s00134-024-07645-8",

language = "English",

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Badulak, J, Abrams, D, Luks, AM, Zakhary, B, Conrad, SA, Bartlett, R, MacLaren, G, Vercaemst, L, Lorusso, R, Broman, LM, Agerstrand, C, Price, S, Combes, A, Peek, G, Fan, E, Shekar, K, Fraser, J, Brodie, D & Extracorporeal Life Support Organization (ELSO) 2024, 'Position paper on the physiology and nomenclature of dual circulation during venoarterial ECMO in adults', Intensive Care Medicine, vol. 50, no. 12, pp. 1994-2004. https://doi.org/10.1007/s00134-024-07645-8

TY - JOUR

T1 - Position paper on the physiology and nomenclature of dual circulation during venoarterial ECMO in adults

AU - Badulak, Jenelle

AU - Abrams, Darryl

AU - Luks, Andrew M.

AU - Zakhary, Bishoy

AU - Conrad, Steven A.

AU - Bartlett, Robert

AU - MacLaren, Graeme

AU - Vercaemst, Leen

AU - Lorusso, Roberto

AU - Broman, Lars Mikael

AU - Agerstrand, Cara

AU - Price, Susanna

AU - Combes, Alain

AU - Peek, Giles

AU - Fan, Eddy

AU - Shekar, Kiran

AU - Fraser, John

AU - Brodie, Daniel

AU - Extracorporeal Life Support Organization (ELSO)

PY - 2024/11/1

Y1 - 2024/11/1

N2 - When native blood flow through the aorta from the adult heart and lungs meets retrograde blood flow from an artificial heart and lung during venoarterial extracorporeal membrane oxygenation (VA-ECMO), the result is the creation of two separate circulations on either side of the blood flow mixing point. This phenomenon is known as dual circulation and is characterized by different content of oxygen and carbon dioxide between the circulations. There is currently a lack of clarity surrounding the nomenclature to describe this physiologic phenomenon in VA-ECMO and thus we endeavor to name and define these terms to facilitate clear communication and proper clinical management of these patients.

AB - When native blood flow through the aorta from the adult heart and lungs meets retrograde blood flow from an artificial heart and lung during venoarterial extracorporeal membrane oxygenation (VA-ECMO), the result is the creation of two separate circulations on either side of the blood flow mixing point. This phenomenon is known as dual circulation and is characterized by different content of oxygen and carbon dioxide between the circulations. There is currently a lack of clarity surrounding the nomenclature to describe this physiologic phenomenon in VA-ECMO and thus we endeavor to name and define these terms to facilitate clear communication and proper clinical management of these patients.

KW - Extracorporeal membrane oxygenation

KW - Extracorporeal life support

KW - Dual circulation

KW - Differential oxygenation

KW - Differential carbon dioxide

KW - Mixing point

KW - EXTRACORPOREAL MEMBRANE-OXYGENATION

KW - VENTRICULAR DISTENSION

KW - HARLEQUIN SYNDROME

KW - MANAGEMENT

U2 - 10.1007/s00134-024-07645-8

DO - 10.1007/s00134-024-07645-8

M3 - (Systematic) Review article

SN - 0342-4642

VL - 50

SP - 1994

EP - 2004

JO - Intensive Care Medicine

JF - Intensive Care Medicine

IS - 12

ER -

Position paper on the physiology and nomenclature of dual circulation during venoarterial ECMO in adults

Abstract

Keywords

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Research output

Correction: Position paper on the physiology and nomenclature of dual circulation during venoarterial ECMO in adults

Cite this