Abstract
The Pillars of Hercules in classical literature indicate the extreme limit of the known world. In addition to a geographic concept, they also metaphorically express the concept of “limit of knowledge.” We read with great interest the editorial: “Beware the Deus Ex Machina of COVID-19” by Wadowski and colleagues.1 The authors give some important consideration to transplant in refractory coronavirus disease 2019 (COVID-19)–associated acute respiratory distress syndrome that may also be driven, in part, by the risks and perceived futility of prolonged veno-venous extracorporeal membrane oxygenation (VV-ECMO) support.
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