Letter to the Editor

Delta-P as an early indicator of oxygenator failure: the case for standardized manufacturer reference values

¹ Perfusion Services, Heart Vascular and Thoracic Institute, Cleveland Clinic, PO Box 112412, Abu Dhabi, United Arab Emirates
² Critical Care Services Administration, As Sulimaniyah, Makkah rd, Riyadh 12231, Saudi Arabia
³ Department of Critical Care, As Sulimaniyah, Makkah rd, Riyadh 12231, Saudi Arabia
⁴ Heart Vascular and Thoracic Institute, Cleveland Clinic, PO Box 112412, Abu Dhabi, United Arab Emirates

^* Corresponding author: This email address is being protected from spambots. You need JavaScript enabled to view it.

Received: 5 July 2025
Accepted: 24 July 2025

Abstract

The evolution of extracorporeal membrane oxygenation (ECMO) has led to an increasing reliance on objective parameters to detect complications early and enhance patient safety. One such parameter is the transmembrane pressure gradient, more commonly referred to as delta P (ΔP), the difference between the inlet and outlet pressures of the oxygenator. This measure has increasingly been recognized as a critical early indicator of thrombus formation within the oxygenator during ECMO support. However, its interpretation remains complex and context-dependent, particularly because delta P values are significantly influenced by the design features of different ECMO circuits, including pump head geometry and oxygenator configuration.