Managing Emergencies in ECMO Patients
A major new consensus guideline on the management of emergencies in patients on Extracorporeal Membrane Oxygenation (ECMO) has been published in the journal Intensive Care Medicine. This critical document is the result of extensive, collaborative work among specialist organisations and clinicians across the UK.
Why This Guideline is Crucial
ECMO is a life-saving but highly complex therapy, and rapid, decisive management of complications is paramount to patient survival. Previously, management strategies for acute ECMO-related emergencies often relied on local protocols, leading to varied practice across different centres.
This new, landmark guideline provides the first comprehensive, multi-society endorsed framework for immediate, evidence-based action across the NHS. The document was carefully produced by experts from multiple national organisations to ensure the advice reflects the broadest possible experience in ECMO delivery, aiming to standardise best practice and improve safety for this highly vulnerable patient group.
What the Guideline Covers
This document addresses the most urgent and challenging scenarios faced by clinicians at the patient's bedside. Key areas covered include:
- System Failure: Clear algorithms for identifying and managing acute circuit, pump, or heat exchanger failure.
- Haemorrhage: Standardised approaches to diagnosing and treating severe bleeding, a frequent and high-risk complication.
- Cannulation Emergencies: Guidance on managing displacement, dissection, and positional issues for both veno-venous (VV) and veno-arterial (VA) ECMO.
- Site-Specific Flowcharts: User-friendly, step-by-step decision tools designed for rapid deployment in high-pressure emergency situations.
Impact and Implementation
This national guidance is essential reading for all intensivists, cardiac surgeons, interventional radiologists, perfusionists, and critical care nurses involved in the care of ECMO patients.
The Intensive Care Society (ICS), which contributed to the collaborative development, strongly encourages all critical care units with ECMO capabilities to immediately review and embed these protocols into local training and practice. By standardising our national response to these complex emergencies, we can collectively enhance patient safety and significantly improve patient outcomes.
Read the full guideline: 'British societies guideline on the management of emergencies in patients on extracorporeal membrane oxygenation' in Intensive Care Medicine.