Abstract
Extracorporeal membrane oxygenation (ECMO) is a highly complex, resource-intensive intervention. The use of veno-venous ECMO for the management of patients with acute, reversible lung failure has increased significantly over the past 10 years. 1 Advances in ECMO technology have resulted in the development of simpler, safer circuits, which are associated with fewer complications. Concomitantly with the clinical and technological changes in ECMO, the role of the ECMO specialist has evolved to manage patient–circuit interaction and the clinical needs of the patient, and to ensure safety of the ECMO circuit through continuous surveillance, assessment and troubleshooting, as well as preventing and managing circuit emergencies. The Extracorporeal Life Support Organization (ELSO) defines the specialist as “the technical specialist trained to manage the ECMO system and clinical needs of the patient on ECMO under direction and supervision of an ECMO trained physician”. 2 Internationally, specialists come from a ra...
Highlights
Support and complex haematological, fluid and sedation management
Advances in Extracorporeal membrane oxygenation (ECMO) technology have resulted in the development of simpler, safer circuits, which are associated with fewer complications
A recent international survey confirmed that despite variation in funding and practice, the staffing arrangement implemented by most centers responding to the survey was the ECMO specialist nurse providing 24/7 ECMO care supported by perfusionist backup for the technical aspects of circuit management.[3]
Summary
Support and complex haematological, fluid and sedation management. In addition to meeting the complex needs of the patient, the ECMO specialist nurse is responsible for ensuring the safe management of the ECMO circuit, which includes the titration of blood flow and sweep gas flow to achieve oxygen and carbon dioxide targets, titrations of blood flows and sweep gas flows to facilitate exercise and the management of emergency situations should they arise.
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