Perfusionist-Led Pediatric ECMO Monitoring in a High-Tech ICU

A Bedside Staffing Model With Perfusionists for Pediatric Extracorporeal Membrane Oxygenation (ECMO) at a High-Volume Center 

This study describes a pediatric ECMO staffing model using perfusionists supported by remote monitoring technology and hourly bedside rounding. Implemented at a high-volume center, the model enables one perfusionist to oversee multiple patients safely. Across 289 cannulations and over 62,000 ECMO hours, outcomes including mortality and complications were comparable to ELSO benchmarks, supporting the model’s safety and feasibility.

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Global Research Trends and Hotspots in Extracorporeal Membrane Oxygenation

Global Research Trends and Hotspots in Extracorporeal Membrane Oxygenation for Cardiogenic Shock: A Bibliometric Review and Knowledge Mapping Approach (1990–2024)

This bibliometric study analyzed global research trends in extracorporeal membrane oxygenation (ECMO) for cardiogenic shock from 1990–2024. Using 701 publications from 55 countries, the authors mapped collaborations, influential institutions, and evolving research themes. Major topics include postcardiotomy shock, extracorporeal cardiopulmonary resuscitation (ECPR), acute myocardial infarction–related shock, and ECMO bridging to transplant. Research focus has shifted toward predictive scoring systems, standardized protocols, and long-term patient outcomes.

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Precision Life Support: VV ECMO Management in the Modern ICU

Evidence-Based Guidelines for the Use of Extracorporeal Membrane Oxygenation in Australia and New Zealand Using GRADE Methodology Series Part 1: Venovenous Extracorporeal Membrane Oxygenation (VV ECMO) Indications and Management

This guideline provides evidence-based recommendations for the use of venovenous extracorporeal membrane oxygenation (VV ECMO) in adult patients with severe respiratory failure. Developed using the GRADE methodology by experts across Australia and New Zealand, it evaluates indications for ECMO, management strategies, proning during ECMO, and ventilation approaches. Evidence suggests ECMO improves short-term survival in severe hypoxic respiratory failure but carries significant risks and resource demands.

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Cardiopulmonary Bypass Supporting High-Risk PCI and TAVR

Cardiopulmonary Bypass as Safe and Effective Support for Concomitant High-Risk Percutaneous Coronary Intervention and Transcatheter Aortic Valve Replacement

This study evaluates the safety and effectiveness of cardiopulmonary bypass (CPB) as hemodynamic support during combined high-risk percutaneous coronary intervention (PCI) and transcatheter aortic valve replacement (TAVR). The authors demonstrate that CPB provides stable circulatory support, enabling complete revascularization and valve implantation in complex patients with severe coronary artery disease and aortic stenosis, with acceptable complication rates and favorable procedural outcomes.

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Seamless Transition: Single-Circuit ECMO to CPB in Pediatric Surgery

ECMO to CPB: A Single Circuit Approach

This technique article describes a novel method for converting pediatric patients from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) to cardiopulmonary bypass (CPB) using a single circuit with the addition of a cardiotomy reservoir. In seven patients (eight procedures), the approach preserved circulating blood volume, limited donor exposure, and maintained effective surgical support. All patients were successfully decannulated, demonstrating feasibility and safety in complex congenital heart surgery.

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Impella vs VA-ECMO in Cardiogenic Shock

Comparative Efficacy and Safety of Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) Versus Impella for Cardiogenic Shock: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis of 10 observational studies (5,364 patients) compared Impella and VA-ECMO for cardiogenic shock. No significant difference in short-term mortality was found (RR 0.92). However, Impella was associated with lower risks of stroke, major bleeding, and limb ischemia. Evidence certainty was very low due to confounding bias. Device selection should be individualized pending randomized trials.

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Elective ECMO Lung Transplant

Elective Use of Intraoperative Extracorporeal Membrane Oxygenation in Patients With Pulmonary Fibrosis Reduces Primary Graft Dysfunction After Bilateral Lung Transplantation

This single-center retrospective study evaluated 422 pulmonary fibrosis patients undergoing bilateral lung transplantation between 2012 and 2025. After adopting a more liberal elective intraoperative veno-arterial ECMO strategy in 2020, the incidence of severe primary graft dysfunction (PGD grade 3 at 72 hours) significantly decreased. Elective ECMO use was associated with shorter ventilation times, reduced dialysis rates, and a trend toward improved one-year graft survival without increasing major vascular complications.

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AI-Powered ECMO Digital Twin in Virtual Reality Training

Building an Extracorporeal Membrane Oxygenation Digital Twin Using High-Resolution Patient Data: An Artificial Intelligence Model for Virtual Reality Simulation 

In this multicentre study of 335 ECMO patients, high-resolution device and electronic health record data were integrated to develop a two-stage artificial intelligence model capable of simulating ECMO circuit behavior and patient physiological responses. The digital twin was deployed in a virtual reality platform with real-time inference. Expert evaluation confirmed clinically coherent responses, supporting scalable, high-fidelity ECMO training without dedicated hardware.

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The Evolving Role of the ECMO Perfusionist

Redefining the Role of Perfusionists in ECMO: From Technical Operators to Clinical Stakeholders

This letter to the editor argues that perfusionists in ECMO programs should move beyond a narrowly defined technical role and be formally integrated as clinical stakeholders. The authors highlight perfusionists’ expertise in circuit management, anticoagulation, device troubleshooting, and physiology, advocating for their inclusion in ICU rounds, decision-making, quality improvement, and research. Greater integration could improve safety, efficiency, and patient outcomes in complex ECMO care.

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Balancing Bleeding and Clotting: Anticoagulation Strategies During ECMO Support

Efficacy of Reduced-Intensity or No Heparin Versus Standard Heparin Anticoagulation in Patients on Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-AnalysiS

This systematic review and meta-analysis of 11 studies (958 ECMO patients) compared reduced-intensity or no heparin anticoagulation with standard heparin strategies. Low/no heparin significantly reduced bleeding complications (OR 0.49) without increasing thrombotic events or in-hospital mortality. Transfusion requirements showed no significant difference. Findings support individualized anticoagulation strategies, though high-quality randomized trials remain needed.

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