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Clinical Perspectives on Extracorporeal Membrane Oxygenation (ECMO)
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Clinical Perspectives on Extracorporeal Membrane Oxygenation (ECMO)

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Intensive Care".

Deadline for manuscript submissions: 20 August 2026 | Viewed by 822

Special Issue Editor

Dr. Alexander Hermann

E-Mail Website
Guest Editor
Intensive Care Unit 13i2, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
Interests: respiratory failure; extracorporeal membrane oxygenation (ecmo); mechanical ventilation; cardiopulmonary resuscitation; septic shock; critical care medicine

Special Issue Information

Dear Colleagues,

ECMO is more than just a device—it is becoming a sophisticated, data-driven, team-oriented cornerstone of modern critical care. As extracorporeal support continues to evolve, so does the mindset of the clinicians who use it: agile, tech-savvy, evidence-focused, and ready to challenge long-held assumptions. This Special Issue captures that momentum and invites the next generation of intensivists, surgeons, nurses, perfusionists, and researchers to redefine what ECMO can mean in the coming decade.

We welcome contributions that push boundaries and introduce new clinical perceptions of ECMO: innovative anticoagulation concepts, smarter approaches to preventing and managing complications, mobile solutions for bringing center expertise to patients, and new therapeutic strategies that strengthen clinical decision-making. Topics such as weaning, escalation and de-escalation pathways, and criteria for futility are more relevant than ever—and this issue aims to serve as a platform to discuss them from multiple professional perspectives.

The future of ECMO will also be shaped by emerging technologies. We therefore encourage submissions exploring the role of artificial intelligence, predictive analytics, advanced imaging, automated monitoring, and machine learning-assisted decision tools. Whether focused on microcirculation, circuit optimization, patient selection, long-term outcomes, or ethical frameworks, we are interested in research that broadens our understanding and enables better, safer, and more personalized care.

Join us in shaping the next chapter of ECMO therapy.

Dr. Alexander Hermann
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • extracorporeal membrane oxygenation (ECMO)
  • extracorporeal life support (ECLS)
  • extracorporeal cardiopulmonary resuscitation (eCPR)
  • extracorporeal gas exchange
  • extracorporeal circulation
  • acute respiratory distress syndrome (ARDS)
  • cardiogenic shock (CS)

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Published Papers (1 paper)

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Research

16 pages, 1337 KB  
Article
Changes in CO2-Derived Variables, Induced by Passive Leg Raising Test, Detect Preload Responsiveness in Mechanically Ventilated Patients: A Pilot Study
by Angeliki Baladima, Stelios Kokkoris, Dimitrios Tzalas, Konstantina Kolonia, Theodora Ntaidou, Theodoros Pittaras, Athanasios Trikas, Ioannis Vasileiadis and Christina Routsi
J. Clin. Med. 2026, 15(4), 1551; https://doi.org/10.3390/jcm15041551 - 15 Feb 2026
Viewed by 504
Abstract
Background/Objectives. Changes in CO2-derived variables during a fluid challenge have been proposed as markers of fluid responsiveness. We investigated whether, instead of fluid administration, passive leg raising (PLR)-induced changes in the CO2-derived variables, namely central venous-arterial carbon dioxide partial [...] Read more.
Background/Objectives. Changes in CO2-derived variables during a fluid challenge have been proposed as markers of fluid responsiveness. We investigated whether, instead of fluid administration, passive leg raising (PLR)-induced changes in the CO2-derived variables, namely central venous-arterial carbon dioxide partial pressure (P(cv-a)CO2) and the ratio between P(cv-a)CO2 and the arterial-central venous oxygen content (P(cv-a)CO2/C(a-cv)O2), could detect preload responsiveness in critically ill patients. Methods. We studied 30 mechanically ventilated patients in whom a PLR test was performed due to acute circulatory failure. Routine hemodynamic variables, velocity-time integral (VTI), in the left ventricular outflow tract, and CO2-derived variables, were measured before, during, and after a PLR test. A PLR-induced increase in VTI of ≥10% defined preload responsiveness. The differences (Δ) of P(cv-a)CO2 and P(cv-a)CO2/C(a-cv)O2 between PLR and pre-PLR were calculated. The predictive values of PLR-induced changes in the CO2-derived variables was determined by receiver operating characteristic area under curves (ROC-AUCs). Results. Fifteen patients (50%) were classified as preload responsive. ΔP(cv-a)CO2 and ΔP(cv-a)CO2/C(a-cv)O2 were correlated with VTI changes and differed significantly between responders and non-responders −1.3 (−2–−0.6) vs. 0.6 (−0.1–1.1) mmHg, p < 0.001, and −0.38 (−0.97–−0.34) vs. 0.1 (−0.15–0.57) mmHg/mL O2, p < 0.001, respectively. The PLR-induced decrease in P(cv-a)CO2 was significantly associated with preload responsiveness (OR 0.48, CI 0.20–0.89, p = 0.016, bootstrap CI 0–0.85). The AUC curves for both ΔP(cv-a)CO2 and ΔP(cv-a)CO2/C(a-cv)O2 ratio to predict preload responsiveness were 0.89 (CI 0.74–1), p < 0.001, and 0.85 (CI 0.70–1), p < 0.001, respectively. Conclusions. In mechanically ventilated ICU patients with circulatory shock, PLR-induced changes in P(cv-a)CO2 and P(cv-a)CO2/C(a-cv)O2 ratio were correlated with VTI changes. The change in P(cv-a)CO2 was the only variable detecting preload responsiveness assessed by PLR; therefore, it could serve as an indirect marker, useful to guide fluid resuscitation when cardiac output measurement is not feasible. Full article
(This article belongs to the Special Issue Clinical Perspectives on Extracorporeal Membrane Oxygenation (ECMO))
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