EuroELSO - Extracorporeal Life Support Organization

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Glossary

1

ECLS (extracorporeal life support)

The umbrella term for supporting heart and/or lung function with a circuit outside the body. ECMO is the most common form; ECLS also covers extracorporeal CO2 removal and related techniques.

2

ECMO (extracorporeal membrane oxygenation)

A circuit that drains venous blood, oxygenates and removes CO2 across a membrane oxygenator, and returns it to the patient. Configured as veno-venous or veno-arterial depending on whether respiratory or cardiac support is the target.

3

VV-ECMO (veno-venous ECMO)

Respiratory support configuration: blood is drained from and returned to the venous system, so the native heart still provides circulation. Used mainly in severe ARDS and other refractory hypoxaemic or hypercapnic respiratory failure.

4

VA-ECMO (veno-arterial ECMO)

Cardiorespiratory support configuration: blood is drained from a vein and returned under pressure to an artery, providing circulatory support in cardiogenic shock, refractory cardiac arrest and post-cardiotomy failure.

5

ECPR (extracorporeal cardiopulmonary resuscitation)

Initiation of VA-ECMO during refractory cardiac arrest, usually in a selected in-hospital or prehospital pathway, alongside conventional CPR and targeted temperature and coronary intervention decisions.

6

Cannulation

Placement of the drainage and return cannulae that connect the patient to the circuit. Site choice (femoral, jugular, subclavian, central or dual-lumen single-site) drives flow limits, recirculation and limb-complication risk.

7

Dual-lumen cannula

A single catheter, usually placed in the internal jugular vein, that drains and returns blood in one device for VV-ECMO. Reduces cannulation sites but demands accurate positioning and imaging confirmation.

8

Membrane oxygenator

The gas-exchange unit of the circuit: blood passes one side of a semipermeable membrane while sweep gas passes the other, adding oxygen and removing CO2. Oxygenator failure shows as falling gas transfer and rising transmembrane pressure.

9

Centrifugal pump

The non-occlusive rotational pump used in most modern ECMO circuits. Flow depends on circuit resistance and preload, so hypovolaemia, kinking or cannula positional problems appear as falling flow rather than as an alarm on a roller pump.

10

Circuit (ECMO circuit)

The complete heparin-coated blood path: drainage line, pump, oxygenator, return line, connectors, sampling ports and pressure monitoring. Circuit choice and configuration are a major topic for both clinicians and exhibiting manufacturers.

11

Sweep gas

The gas mixture, usually oxygen with or without air, passed through the oxygenator's gas compartment. Sweep gas flow controls CO2 removal; the fraction of oxygen delivered controls oxygenation across the membrane.

12

ACT (activated clotting time)

A point-of-care clotting test used at the bedside to titrate unfractionated heparin during ECMO. Target ranges differ between centres and between bleeding and thrombotic phases of a run.

13

Left ventricular distension (venting)

A complication of VA-ECMO in which the returning arterial pressure raises afterload while the failing left ventricle cannot eject, causing blood stasis, pulmonary oedema and thrombus risk. Managed by unloading strategies including inotropes, atrial septostomy, Impella or a surgical vent.

14

ECMELLA

Combined mechanical support using VA-ECMO plus a percutaneous microaxial left ventricular assist device (Impella). Used in selected cardiogenic shock patients to unload the left ventricle while maintaining systemic flow.

15

ECCO2R (extracorporeal CO2 removal)

Lower-blood-flow extracorporeal techniques aimed primarily at CO2 clearance, used to enable protective ventilation or avoid intubation in selected hypercapnic respiratory failure.

16

Mobile ECMO / retrieval team

A trained team that travels to a referring hospital to cannulate and transfer a patient on ECMO. Requires equipment, governance, transport logistics and 24/7 staffing, and is a recurring service-design theme at EURO-ELSO.

17

ARDS (acute respiratory distress syndrome)

Acute inflammatory lung injury with bilateral infiltrates and severe hypoxaemia. A core VV-ECMO indication when conventional ventilation, prone positioning and other measures fail.

18

Cardiogenic shock

Inadequate tissue perfusion caused by cardiac dysfunction, often after myocardial infarction or cardiac surgery. The main VA-ECMO indication discussed at the congress, together with patient selection and escalation and de-escalation timing.

19

ELSO (Extracorporeal Life Support Organization)

The international non-profit body that publishes ECLS guidelines, maintains the ELSO Registry of ECMO runs worldwide, and coordinates a network of centres and regional chapters, including EuroELSO.

20

Perfusionist

A allied health professional trained in extracorporeal circulation, responsible for cardiopulmonary bypass and, in many centres, for ECMO circuit priming, management and troubleshooting.

21

Weaning and decannulation

The structured reduction of ECMO support once native organ recovery is judged sufficient, followed by removal of cannulae and haemostasis. Protocols for readiness testing, trial-off periods and post-decannulation monitoring vary widely between centres.