From the Editors\' Desk

Extracorporeal life support in India continues to evolve from an emergent rescue modality into a structured and evidence-driven component of critical care practice.This maturation is reflected not only in expanding clinical capacity but also in the increasing scholarly engagement from centers across the country.The uniqueness of this attribute is adaptation to the local challenges, such as treating various poisonings and other diseases having the potential for recovery on removing the toxin and supporting the organ systems.Another quality we observed is the development of jugaad systems for working efficiently by minimising the costs.We truly believe in realising the dream of "ECMO Economics".The present issue of the Indian Journal of ECMO (IJECMO) reflects the growing maturity of extracorporeal life support practice in India.As ECMO becomes integrated into advanced critical care pathways, the need for high-quality, context-specific evidence is increasingly critical.The contributions in this edition advance our understanding of ECMO across diverse physiological, logistical, and disease-specific settings, strengthening the foundation of a robust national ECMO knowledge base.The original research on Paediatric VV ECMO Flow-related Problems provides essential insights into circuit dynamics in pediatric patients, addressing a notable gap in national data.The analysis of Inter-Hospital ECMO Transport in the Pre-and Post-COVID Era highlights the operational challenges and evolving safety of retrieval systems, reinforcing the importance of structured regional coordination.The case reports presented here demonstrate ECMO's expanding clinical relevance-from COVID-19 MIS-C cardiogenic shock and airway haemorrhage during VV ECMO to occasional cases of crisis management with ECMO-assisted liver transplantation and innovative strategies such as dual oxygenator support in severe H1N1 ARDS.Experiences in toxicology, including aluminium phosphide-induced refractory shock, further underscore the unique Indian context where ECMO can be transformative.The case series on VV ECMO in MODS contributes meaningfully to ongoing discussions on patient selection.The present issue reflects the growing sophistication, adaptability and evidence-driven evolution of ECMO practice in the country.We extend our sincere gratitude to all authors, reviewers, and contributing centers for their commitment to advancing ECMO science and for sharing valuable clinical experience that strengthens the collective knowledge of our community.Their efforts continue to shape the trajectory of ECMO practice in India and support the journal's mission of fostering high-quality, context-relevant scholarship.ECMO community lost its founding father, philosopher, Guru, Dr Robert (Bob) Barlett.We trust, he continues to be with us, guiding us in our work, devotion and exploration of innovative ways of doing ECMO, reaching the common objective of saving lives.One of Bob's favourite talks was "ECMO physiology".It reminds us about the relevance and importance of exploring at grassroot level to find answers to the complex issues.May his divine soul show the path in finding solutions to human misery and disease.