What does the term "north-south syndrome" refer to?

The term "north-south syndrome" refers to the phenomenon observed in patients who experience cardiac recovery while still facing ongoing respiratory compromise. In this context, it is often seen in ECMO scenarios where the heart demonstrates improved function and perfusion but the lungs remain insufficient in providing adequate gas exchange. The 'north' part symbolizes the heart (as it is often located in the upper part of the body or reference to north), and the 'south' refers to the lungs (lower part of the body or reference to south). This terminology highlights the disparity in the recovery of cardiac and pulmonary functions, making a critical distinction in patient management post-ECMO support or during cardiac interventions.

Recognizing this syndrome is essential for clinicians as it directs the focus of ongoing treatment—after cardiac function stabilizes, addressing respiratory status becomes a priority to ensure overall patient recovery.