Reviewed and revised 29 April 2018
ECMO is extracorporeal membrane oxygenation, also known as ECLS (extracorporeal life support).
The Alfred ICU has provided ECMO care since 1990 and has now provided ECMO support for more than 500 patients, at a current rate of over 100 patients per year.
An ECMO Clinical Service, independent from Perfusion Services, was established in 2003 to improve ECMO delivery and bedside care. The philosophy of the ECMO Clinical Service is that ECMO is best provided as an integrated Intensive Care patient support modality. Training programs, competency maintenance, credentialing requirements, protocols, preventative strategies and consultative Perfusion Service input are components of our integrated ECMO Service. The ECMO service is actively involved in ongoing research as well. The development of this service has led to the Alfred ICU becoming one of only five recipients of the ELSO Platinum level Centre of Excellence designation and the only such centre outside of the United States.
ECMO Education at the Alfred ICU
Twice a year, the Alfred ICU runs the Alfred ICU and Perfusion Adult ECMO Course as well as a Cannulation course, both of which are open to external participants.
Senior Registrars and Fellows at the Alfred ICU have the opportunity to complete the ‘Alfred ICU ECMO Certificate‘, which requires sufficient clinical exposure, attendance at didactic and simulation-based teaching sessions, contribution to the education programme and completion of the Alfred ICU and Perfusion Adult ECMO Course.
ECMO cases, issues and developments are discussed at the monthly ECMO Special Interest Group meeting and regular inter-professional, inter-departmental ECPR simulations are performed.
The ‘Everything ECMO’ series
This is a developing series of peer-reviewed case-based Q&A blog posts published on INTENSIVE covering all aspects of ECMO management in critically ill patients.
- 001 — Persistent hypoxaemia on VV ECMO
- 002 — VV ECMO ventilation and weaning
- 003 — An ECMO earthquake? (access insufficiency)
- 004 — Why is the bag turning red? (haemolysis)
- 005 — Cardiac arrest on VV ECMO
- 006 — Access insufficiency is just the beginning… (complications of VV ECMO and necrotizing pneumonia)
- 007 — What is different about hypoxia on VA ECMO? (differential hypoxia aka Harlequin Syndrome)
- 008 — Weaning from VA ECMO
- 009 — Differential hypoxia in reverse?! (pseudo-differential hypoxia and reverse differential hypoxia)
- 010 — Keep calm and cannulate! (ECMO cannulation)
- 011 — Go with the flow (High-flow VV ECMO configuration)
- 012 — Turn and face the circuit… ch-ch-change it! (ECMO circuit change)
- 013 — Pump it! (Ventricular Assist Device (VAD) concepts)
- 014 — Not just little adults… ECMO and paediatric lung transplantation
- 015 — Cardiac arrest on ECMO… Does it still count? (ECMO cardiac arrest)
- 016 — Holy HITTS! (Oxygenator thrombosis, HITTS)
- 017 — ECMO Circuit Rupture!
- 018 — ECMO Cannula Rupture!
- 019 — Bad bubbles and VV-ECMO (Air embolus on VV ECMO)
- 020 — “Pink fluid coming up the tube”.. ECMO, LV distention, and more!
- 021 — How to “Ace the Avalon”! (Dual Lumen Cannula for VV ECMO)
ECPR on INTENSIVE
The Alfred ECMO Service is among the pioneers of ECPR. ECPR content on INTENSIVE includes:
Other ECMO resources
- A Primer on Priming the PLS circuit (video)
- Echo-guided bicaval dual lumen ECMO catheter insertion (Avalon Elite)
- ECMO in San Diego
- ECMO: What could go wrong? (podcast by Deirdre Murphy)
- No mistakes with ECMO
- Quick tips from the Alfred ICU ECMO course
- Weaning VA ECMO on ECMO.org (podcast with Deirdre Murphy)