Standardization of In-Vitro Evaluation of Extracorporeal Life Support (ECLS) Devices for Research and Development

April 5, 2026 No Comments

This guideline article argues that extracorporeal life support device testing should follow standardized in-vitro protocols so results can be reproduced, compared across research groups, and translated more effectively into practice. It outlines reporting criteria, relevant ISO standards, preferred test conditions, and key considerations for pumps, oxygenators, cannulae, tubing, hemolysis, and thrombogenicity assessment.

ECMO Anticoagulation Innovation in Critical Care

Alternate and Emerging Anticoagulation Strategies for Extracorporeal Membrane Oxygenation: A Scoping Review

March 31, 2026 No Comments

This scoping review maps the evidence on ECMO anticoagulation strategies beyond unfractionated heparin. Across 135 included records, direct thrombin inhibitors—especially bivalirudin—were the most studied alternatives, while nafamostat, prostaglandin E1, circuit modifications, anticoagulation-free protocols, and newer monitoring tools remain emerging areas. The authors conclude that ECMO anticoagulation is shifting toward more personalized, diversified management.

Bridging the Distance: Pediatric ECMO Access Across America

State and Regional Variation in Access to Pediatric Extracorporeal Membrane Oxygenation

March 30, 2026 No Comments

This geospatial cross-sectional study examined how access to pediatric extracorporeal membrane oxygenation varies across U.S. states and Pediatric Emergency Referral Regions. Researchers identified 258 pediatric ECMO centers and 169 ECPR centers, finding major differences in direct access, especially in rural areas. Although interfacility transport made ECMO access nearly universal in many places, access to ECPR remained very limited for most children.

Bright Neonatal ECMO Team Managing Oxygen Targets

Impact of Early Hyperoxia on Outcomes During Neonatal and Pediatric Veno-Arterial Extracorporeal Life Support

March 26, 2026 No Comments

This single-center retrospective cohort study examined 229 neonatal and pediatric VA-ECLS patients and found that early hyperoxia was common, affecting 79% of cases. Severe hyperoxia, defined as PaO2 above 300 mmHg, was linked to more cardiovascular or renal complications, but it was not independently associated with in-hospital mortality, acute kidney injury, or worse functional outcomes after adjustment. The authors support standardized oxygen targets during VA-ECLS.

Global Bridge to Heart Transplant With Prolonged Impella 5.5 Support

Impact of Prolonged Impella 5.5 Support on Post-Transplant Outcomes: An Institutional Study

March 26, 2026 No Comments

This institutional retrospective study evaluated 72 patients bridged to heart transplant with the Impella 5.5 and compared outcomes for support durations of 14 days or less versus more than 14 days. Prolonged support did not worsen 1-year survival, graft rejection, length of stay, or major complications. Although rehospitalization within a year was common, overall survival was excellent, supporting extended Impella 5.5 use as a safe bridge-to-transplant strategy.

Clinician Perspectives on the Extracorporeal Membrane Oxygenation Decision-Making Process

March 23, 2026 No Comments

This qualitative study explores how clinicians determine candidacy for venovenous ECMO in severe respiratory failure. Interviews with 24 clinicians across 9 countries revealed that decisions rely heavily on subjective judgment rather than standardized criteria. Factors such as age, BMI, ventilator duration, social context, and institutional resources vary widely in interpretation. Cognitive biases and ethical considerations further influence decisions, leading to inconsistent and potentially inequitable allocation of this life-saving but resource-intensive therapy.

Anticoagulation Management and Monitoring in ECMO: An International Survey From the ISTH SSC Subcommittee on Pediatric and Neonatal Thrombosis and Hemostasis

March 22, 2026 No Comments

This international survey evaluates anticoagulation strategies in ECMO patients across 17 countries. Findings show unfractionated heparin remains the primary anticoagulant, while bivalirudin use is rising. Despite widespread protocol use, significant variability persists in dosing, monitoring, and transfusion practices. Hematology involvement is often limited to complex cases, highlighting the need for standardized, collaborative approaches to improve ECMO outcomes.

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

March 19, 2026 No Comments

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.

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

March 14, 2026 No Comments

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.

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

March 7, 2026 No Comments

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.