Although trainees become technically proficient at initiating extracorporeal membrane oxygenation (ECMO) and grow accustomed to the pressure of cannulating patients in unstable scenarios, there is still much to learn when it comes to the decision-making progress, according to a Fellows in Training/Early Career column published March 5 in the Journal of the American College of Cardiology.

Jason Han, MD, et al., describe an event where an emergent decision must be made to a seemingly lifeless patient on whether he qualifies as a good ECMO candidate or not. The authors describe the stipulations of EMCO, and state that because its risks are commensurate with its life-saving potential, this technology must be used selectively to avoid doing more harm.

“One day each of us will surely bear the responsibility of making a decision as seemingly leading actors,” the authors write. “Perhaps, by then, more experience and evidence will have brought us closer to defining the ‘perfect’ ECMO candidate.” Read more.