Recirculation in venovenous extracorporeal membrane oxygenation

Abrams and colleagues provide a comprehensive review of the topic of recirculation during VV ECMO.  Specifically, the authors discuss the factors contributing to recirculation, how to calculate the extent of recirculation, and what interventions can be applied to correct the issue.  Recirculation can be a significant challenge during VV ECMO, particularly in patients that have worse underlying pulmonary function.  For ECMO programs, this article is a "must-have" to distribute to fellows, residents, and other health care providers managing these patients.