Unloading the left ventricle in venoarterial extracorporeal life support: The urgent need of speaking the same language!

Reply from authors: Defining ventricular distension on extracorporeal membrane oxygenation and triggers to intervene

“…We thank you for your kind words and your thoughtful comments. 1 We completely agree that left ventricular (LV) distension can result in catastrophic effects such as thrombus formation, compromise LV recovery, and that its importance should be emphasized in the management of patients with cardiogenic shock supported with venoarterial extracorporeal membrane oxygenation (ECMO). A commonly agreed-upon definition of LV distension is central to future research efforts aiming to provide evidence-based management strategies.…”

“…The strength of definition proposed by Meani and colleagues 1 is that it provides clinicians with a constellation of signs on which to base management decisions. Isolated reduction in stroke volume as indicated by a left ventricular outflow tract (LVOT) velocity–time integral of <10 cm/s may reflect a profoundly depressed LV systolic function that may predispose to the development of LV dilatation and pulmonary congestion.…”